Provider Demographics
NPI:1063901601
Name:LIMBAG, WILHELMINA FIGUERREZ
Entity type:Individual
Prefix:
First Name:WILHELMINA
Middle Name:FIGUERREZ
Last Name:LIMBAG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3775 63RD ST APT A51
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-2653
Mailing Address - Country:US
Mailing Address - Phone:646-703-2557
Mailing Address - Fax:
Practice Address - Street 1:3775 63RD ST APT A51
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-2653
Practice Address - Country:US
Practice Address - Phone:646-703-2557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRE00413657-GFDC174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty