Provider Demographics
NPI:1144472549
Name:VILLATORO, MARIA PAGANO (BS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:PAGANO
Last Name:VILLATORO
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 BELLMAWR DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-4626
Mailing Address - Country:US
Mailing Address - Phone:585-736-8559
Mailing Address - Fax:
Practice Address - Street 1:55 BELLMAWR DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14624-4626
Practice Address - Country:US
Practice Address - Phone:585-736-8559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021781225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY30-0213081OtherTAX ID