Provider Demographics
NPI:1861718223
Name:VILLANUEVA, ERIKA (MD)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:VILLANUEVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CAPITAL WAY STE 290
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-2521
Mailing Address - Country:US
Mailing Address - Phone:609-303-4300
Mailing Address - Fax:609-303-4301
Practice Address - Street 1:2 CAPITAL WAY STE 290
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2521
Practice Address - Country:US
Practice Address - Phone:609-303-4300
Practice Address - Fax:609-303-4301
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-10
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269981207RE0101X, 261Q00000X, 282N00000X
282N00000X
NJ25MA10117600207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care Hospital