Provider Demographics
NPI:1497892947
Name:VILLANI, JOANNE C (PT)
Entity Type:Individual
Prefix:MISS
First Name:JOANNE
Middle Name:C
Last Name:VILLANI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 BAR BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4002
Mailing Address - Country:US
Mailing Address - Phone:516-767-9128
Mailing Address - Fax:516-767-9128
Practice Address - Street 1:4180 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-5303
Practice Address - Country:US
Practice Address - Phone:516-541-7500
Practice Address - Fax:516-541-7503
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008882-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor