Provider Demographics
NPI:1417483801
Name:VILLARIN, JOSEPH MANUEL
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MANUEL
Last Name:VILLARIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 RIVERSIDE DR
Mailing Address - Street 2:APT. 16A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1001
Mailing Address - Country:US
Mailing Address - Phone:917-533-0625
Mailing Address - Fax:
Practice Address - Street 1:1380 RIVERSIDE DR
Practice Address - Street 2:APT. 16A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1001
Practice Address - Country:US
Practice Address - Phone:917-533-0625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-04
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program