Provider Demographics
NPI:1447201827
Name:VILLENEUVE, JOHN B
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:VILLENEUVE
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:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6TH AVENUE AND SPRUCE STREET
Practice Address - Street 2:N BLDG GROUND FLOOR
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1428
Practice Address - Country:US
Practice Address - Phone:610-988-8905
Practice Address - Fax:610-988-5189
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD064792L207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017180350004Medicaid
NJ7799403Medicaid
G21688Medicare UPIN
PA020640Medicare PIN