Provider Demographics
NPI:1982656195
Name:VILLANUEVA, HOPE CHONA TAN (PT)
Entity Type:Individual
Prefix:
First Name:HOPE CHONA
Middle Name:TAN
Last Name:VILLANUEVA
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 1:34 BRIAR LN
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-3002
Mailing Address - Country:US
Mailing Address - Phone:201-699-2925
Mailing Address - Fax:201-699-2925
Practice Address - Street 1:34 BRIAR LN
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-3002
Practice Address - Country:US
Practice Address - Phone:201-699-2925
Practice Address - Fax:201-699-2925
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01016800225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist