| Doctor Name: | VIRGINIA GUANCO-VILLANUEVA |
| NPI Number: | 1033343884 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.P.N. |
| License Number: | 26NJ00021200 |
| Business Practice Address: | 240 Williamson St Suite 403 Elizabeth, NJ - 072023674 |
| Business Phone Number: | 9082896996 |
| Business Fax Number: | |
| Mailing Address: | 240 Williamson St, Suite 403 ELIZABETH |
| State: | NJ |
| Postal Code: | 072023674 |
| Phone Number: | 9082896996 |
| Fax Number: | |
| NPI Enumeration Date: | 05/07/2009 |
| NPI Last Update Date: | 11/18/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 26NJ00021200 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |