Villajuan, Bernardo R

Villajuan, Bernardo R is an individual health care provider with primary practice located at 319 Broadway , Fort Edward NY 12828-1221. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Villajuan, Bernardo R can be contacted via phone (518) 761-0300.

Contact Information

Primary practice address
319 Broadway Fort Edward NY 12828-1221
Phone: (518) 761-0300
Fax: (518) 480-0119
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 115492 New York

Profile Details

NPI number 1033220397
LBN Legal business name Villajuan, Bernardo R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Jan 31st, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033220397 NPPES
New York MEDICAID 00366569

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