| Doctor Name: | LESLIE V VILLANUEVA |
| NPI Number: | 1023352788 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APN |
| License Number: | 2600396800 |
| Business Practice Address: | 92 Summit Ave Hackensack, NJ - 076011263 |
| Business Phone Number: | 2013420066 |
| Business Fax Number: | |
| Mailing Address: | 389 Westminster Pl, LODI |
| State: | NJ |
| Postal Code: | 076441218 |
| Phone Number: | 2016631203 |
| Fax Number: | |
| NPI Enumeration Date: | 11/19/2012 |
| NPI Last Update Date: | 11/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP2300X |
| License Number: | 2600396800 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |