Provider Demographics
NPI:1891877478
Name:VILLARIN, PORFIRIO (MD)
Entity Type:Individual
Prefix:
First Name:PORFIRIO
Middle Name:
Last Name:VILLARIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:745 64TH ST
Mailing Address - Street 2:DEVELOPMENTAL CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220-4753
Mailing Address - Country:US
Mailing Address - Phone:718-283-1900
Mailing Address - Fax:718-635-6745
Practice Address - Street 1:745 64TH ST
Practice Address - Street 2:DEVELOPMENTAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4753
Practice Address - Country:US
Practice Address - Phone:718-283-1900
Practice Address - Fax:718-635-6745
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1729082084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry