Provider Demographics
NPI:1609094606
Name:VIL, NATHALIE (RPA-C)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:
Last Name:VIL
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E 82ND ST
Mailing Address - Street 2:APT. 1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3305
Mailing Address - Country:US
Mailing Address - Phone:718-753-2409
Mailing Address - Fax:
Practice Address - Street 1:187 CONKLIN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3727
Practice Address - Country:US
Practice Address - Phone:718-408-4949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011177363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant