Provider Demographics
NPI:1124121397
Name:VILAN, RONIT (DC)
Entity type:Individual
Prefix:
First Name:RONIT
Middle Name:
Last Name:VILAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4571
Mailing Address - Country:US
Mailing Address - Phone:201-798-2922
Mailing Address - Fax:201-798-0307
Practice Address - Street 1:3 CANDOR DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2203
Practice Address - Country:US
Practice Address - Phone:516-677-0411
Practice Address - Fax:516-677-0171
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007943111N00000X
NJ38MC00709400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU70336Medicare UPIN
NYX6A511Medicare ID - Type Unspecified