Individual
THELMA L VILLANUEVA
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
525 HIGHWAY 70, BRICK, NJ 08723
(732) 920-2424
(732) 920-1211
Mailing address
525 HIGHWAY 70, BRICK, NJ 08723
(732) 920-2424
(732) 920-1211
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA02883300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2524007
—
NJ
Enumeration date
02/21/2006
Last updated
07/08/2007
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