Provider Demographics
NPI:1215720057
Name:VILLEGAS, MAYLEGN (RN)
Entity type:Individual
Prefix:
First Name:MAYLEGN
Middle Name:
Last Name:VILLEGAS
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 1:42 QUAKER AVE
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-2109
Mailing Address - Country:US
Mailing Address - Phone:914-502-8120
Mailing Address - Fax:
Practice Address - Street 1:42 QUAKER AVE
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-2109
Practice Address - Country:US
Practice Address - Phone:914-502-8120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-24
Last Update Date:2025-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
253Z00000X, 261Q00000X
NY948601163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No253Z00000XAgenciesIn Home Supportive Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center