Provider Demographics
NPI:1023995933
Name:TAH, VILLEROY (DR)
Entity type:Individual
Prefix:
First Name:VILLEROY
Middle Name:
Last Name:TAH
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WHITEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-1300
Mailing Address - Country:US
Mailing Address - Phone:508-816-4036
Mailing Address - Fax:
Practice Address - Street 1:12 WHITEWOOD RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-1300
Practice Address - Country:US
Practice Address - Phone:508-816-4036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2294264163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health