ELIZABETH VILLAVICENCIO NURSE PRACT NPI 1790772010

NPI Information

NPI: 1790772010
Provider Name: ELIZABETH VILLAVICENCIO, NURSE PRACT
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

Address:
347 EDISON ST
STATEN ISLAND, NY
ZIP 10306
Phone: (718) 351-1136
Get Directions

Elizabeth Villavicencio, NURSE PRACT is a pediatrics nurse practitioner in Staten Island, NY. Elizabeth Villavicencio, NURSE PRACT NPI is 1790772010. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

347 EDISON ST
STATEN ISLAND, NY
ZIP 10306-034
Phone: (718) 351-1136
Fax: (718) 667-9711

The enumeration date for this NPI number is 10/3/2005 and was last updated on 11/9/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	F3814531	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	1093G1	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
2	02389417	MEDICAID	NEW YORK
3	Q44233	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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