Provider Demographics
NPI:1437205820
Name:VILLAFUERTE, ALBERT V (MD)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:V
Last Name:VILLAFUERTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 BATHGATE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-8216
Mailing Address - Country:US
Mailing Address - Phone:718-618-7923
Mailing Address - Fax:718-618-7925
Practice Address - Street 1:1575 BATHGATE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-8216
Practice Address - Country:US
Practice Address - Phone:718-618-7923
Practice Address - Fax:718-618-7925
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA2025991208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
H30952Medicare UPIN