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Individual

VICTOR G. VILLAGRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
76 RIVERVIEW AVENUE, NOANK, CT 06340
(860) 614-2563
Mailing address
76 RIVERVIEW AVENUE, NOANK, CT 06340
(860) 614-2563

Taxonomy

Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
035741
CT
2083P0901X
Public Health & General Preventive Medicine Physician
965811
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
965811
MEDICAL LICENSE NUMBER
CT
Enumeration date
12/04/2020
Last updated
01/14/2021
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