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Individual

WENDELL VILLANUEVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
303 5TH AVE RM 1413, NEW YORK, NY 10016-6628
(212) 481-8678
Mailing address
303 5TH AVE RM 1413, NEW YORK, NY 10016-6628
(212) 481-8678

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
612828
NY
163WP0200X
Pediatric Registered Nurse
Primary
612828
NY

Other

Enumeration date
06/29/2010
Last updated
06/29/2010
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