Doctor Name: | ANDREA MARTINEZ VILLALOBOS |
NPI Number: | 1003280041 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RPA-C |
License Number: | 018884 |
Business Practice Address: | 9014 Elmhurst Ave Second Floor Jackson Heights, NY - 113727936 |
Business Phone Number: | 7182687337 |
Business Fax Number: | 7182687377 |
Mailing Address: | 9014 Elmhurst Ave, Second Floor JACKSON HEIGHTS |
State: | NY |
Postal Code: | 113727936 |
Phone Number: | 7182687337 |
Fax Number: | 7182687377 |
NPI Enumeration Date: | 11/13/2015 |
NPI Last Update Date: | 11/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 018884 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |