Provider Demographics
NPI:1184990913
Name:VILLOSO, KAREN (RN)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:VILLOSO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:468 E 140TH ST
Mailing Address - Street 2:RM 117
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10454-2752
Mailing Address - Country:US
Mailing Address - Phone:718-292-2237
Mailing Address - Fax:718-292-3623
Practice Address - Street 1:468 E 140TH ST
Practice Address - Street 2:RM 117
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-2752
Practice Address - Country:US
Practice Address - Phone:718-292-2237
Practice Address - Fax:718-292-3623
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY608478163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool