Provider Demographics
NPI:1558417915
Name:VILLAROSA, JOAN PASOS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:PASOS
Last Name:VILLAROSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JOAN
Other - Middle Name:PASOS
Other - Last Name:VILLAROSA-SISANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:998 CROOKED HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-1043
Mailing Address - Country:US
Mailing Address - Phone:631-761-3500
Mailing Address - Fax:631-761-3630
Practice Address - Street 1:998 CROOKED HILL RD
Practice Address - Street 2:
Practice Address - City:WEST BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1043
Practice Address - Country:US
Practice Address - Phone:631-761-3500
Practice Address - Fax:631-761-3630
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1730452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry