Individual
JOHANNA MONSALVE VILLAMIZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-5400
(631) 444-7538
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
(631) 444-5400
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
302922
NY
2085R0202X
Diagnostic Radiology Physician
68540
ZZ
Other
Enumeration date
01/27/2014
Last updated
04/20/2022
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