Provider Demographics
NPI:1528898558
Name:VILLAFANE, LUIS
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:VILLAFANE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 ORANGE TER
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-6305
Mailing Address - Country:US
Mailing Address - Phone:845-742-6027
Mailing Address - Fax:
Practice Address - Street 1:19 ORANGE TER
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-6305
Practice Address - Country:US
Practice Address - Phone:845-742-6027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics