Provider Demographics
NPI:1760824080
Name:VILLAHERMOSA, MAJHI MARIE
Entity Type:Individual
Prefix:
First Name:MAJHI MARIE
Middle Name:
Last Name:VILLAHERMOSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3009 45TH ST APT 5
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-1848
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11 E 47TH ST FL 2
Practice Address - Street 2:ENJOY REHAB PTPC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-1919
Practice Address - Country:US
Practice Address - Phone:646-577-1054
Practice Address - Fax:646-200-5064
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-28
Last Update Date:2013-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY035570-1261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy