Provider Demographics
NPI:1386035178
Name:WOO VILLANUEVA, FLORENCE
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:
Last Name:WOO VILLANUEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLORENCE
Other - Middle Name:
Other - Last Name:WOO-VILLANUEVA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10015 QUEENS BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2465
Mailing Address - Country:US
Mailing Address - Phone:347-813-4960
Mailing Address - Fax:347-813-4989
Practice Address - Street 1:10015 QUEENS BLVD STE 202
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2465
Practice Address - Country:US
Practice Address - Phone:347-813-4960
Practice Address - Fax:347-813-4989
Is Sole Proprietor?:No
Enumeration Date:2015-02-15
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04599437Medicaid