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Individual

PORTIA VILLALONA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601-6211
(718) 360-9370
Mailing address
2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601-6211
(718) 360-9370
(718) 841-9438

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F-335821
NY
363LF0000X
Family Nurse Practitioner
F335821
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1609202175
NY
05
1922334358
NY
Enumeration date
09/17/2013
Last updated
01/08/2021
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