Individual
JUDITH VILLAVICENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
63 HARRISON AVE, FRANKLIN SQUARE, NY 11010-3614
(646) 525-7774
Mailing address
63 HARRISON AVE, FRANKLIN SQUARE, NY 11010-3614
(646) 525-7774
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
027711-01
NY
Other
Enumeration date
01/31/2026
Last updated
01/31/2026
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