Most Relevant Information
Provider Data
| NPI Number: | 1003280041 |
| Provider Name: | ANDREA MARTINEZ VILLALOBOS RPA-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363AM0700X |
| Specialty: | Physician Assistant |
| License Number: | 018884 |
Most Important Dates
| Enumeration Date: | 11/13/2015 |
| Last Updated: | 02/10/2021 |
Provider Practice Location
159 CARLETON AVE
CENTRAL ISLIP
NY
117224172
Practice Location Phone/Fax
| Phone: | 6316502510 |
| Fax: | 6316500497 |
Provider Mailing Location
9033 ELMHURST AVE
JACKSON HEIGHTS
NY
113727935
Provider Mailing Phone/Fax
| Phone: | 7184577000 |
| Fax: | 7188994955 |