Most Relevant Information
Provider Data
| NPI Number: | 1003457086 |
| Provider Name: | BRYAN JOEL VILLANUEVA NITURAL DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 208100000X |
| Specialty: | Physical Medicine & Rehabilitation |
| License Number: | 038911 |
Most Important Dates
| Enumeration Date: | 10/01/2019 |
| Last Updated: | 10/01/2019 |
Provider Practice Location
820 2ND AVE RM 6A
NEW YORK
NY
100174530
Practice Location Phone/Fax
| Phone: | 9292456596 |
| Fax: |
Provider Mailing Location
3975 56TH ST APT 1J
WOODSIDE
NY
113778904
Provider Mailing Phone/Fax
| Phone: | 9292456596 |
| Fax: | 3473321651 |