Individual
DALIDA F VILLACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2510 WESTCHESTER AVE, BRONX, NY 10461-3585
(347) 802-4156
Mailing address
8600 BOULEVARD E APT 1D, NORTH BERGEN, NJ 07047-6083
(201) 751-5751
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
707354
NY
Other
Enumeration date
06/13/2012
Last updated
09/02/2014
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