Provider Demographics
NPI:1427922962
Name:VILLEGAS, PRINCE VIRO SAEZ
Entity type:Individual
Prefix:
First Name:PRINCE VIRO
Middle Name:SAEZ
Last Name:VILLEGAS
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 1:96 MAIDEN LN
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-4526
Mailing Address - Country:US
Mailing Address - Phone:530-490-9185
Mailing Address - Fax:
Practice Address - Street 1:96 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4526
Practice Address - Country:US
Practice Address - Phone:530-490-9185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014755225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant