Provider Demographics
NPI:1245322072
Name:VILLAGE FAMILY MEDICINE PA
Entity type:Organization
Organization Name:VILLAGE FAMILY MEDICINE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUYANDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:919-968-4551
Mailing Address - Street 1:109 CONNER DR
Mailing Address - Street 2:SUITE 1101
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-7041
Mailing Address - Country:US
Mailing Address - Phone:919-968-4551
Mailing Address - Fax:919-929-7405
Practice Address - Street 1:109 CONNER DR
Practice Address - Street 2:SUITE 1101
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-7039
Practice Address - Country:US
Practice Address - Phone:919-968-4551
Practice Address - Fax:919-929-7405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty