Individual
ANDREA VILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9777 QUEENS BLVD PH, REGO PARK, NY 11374-3300
(718) 830-9274
Mailing address
3345 60TH PL, WOODSIDE, NY 11377-2221
(646) 483-8827
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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