Provider Demographics
NPI:1548501430
Name:VILLEGAS, LAURA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:VILLEGAS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:SCHMALZLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 CANAL ST
Mailing Address - Street 2:
Mailing Address - City:ELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12428-1403
Mailing Address - Country:US
Mailing Address - Phone:845-647-6222
Mailing Address - Fax:845-647-1558
Practice Address - Street 1:101 CANAL ST
Practice Address - Street 2:
Practice Address - City:ELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12428-1400
Practice Address - Country:US
Practice Address - Phone:845-647-6222
Practice Address - Fax:845-647-1558
Is Sole Proprietor?:No
Enumeration Date:2013-03-03
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYI057791183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist