Individual
CYNTHIA D. VILLASIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
65 W JIMMIE LEEDS RD, CHOP CARE NETWORK @ ATLANTICARE, POMONA, NJ 08240-9102
(609) 404-3816
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9232
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD036907L
PA
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
MD036907L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007930170010
—
PA
01
—
10938189
CAQH ID#
PA
01
—
2253288
CIGNA HMO/PPO
PA
01
—
417451
HIGHMARK BLUE SHIELD
PA
Enumeration date
05/18/2006
Last updated
03/24/2014
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