Provider Demographics
NPI:1992267280
Name:VILLAR, JUAN JOSE EDUARDO (MD)
Entity type:Individual
Prefix:DR
First Name:JUAN JOSE
Middle Name:EDUARDO
Last Name:VILLAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1 RADISSON PLZ FL 9
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-5768
Mailing Address - Country:US
Mailing Address - Phone:914-369-1934
Mailing Address - Fax:
Practice Address - Street 1:1 RADISSON PLZ FL 9
Practice Address - Street 2:
Practice Address - City:NEW ROCHELLE
Practice Address - State:NY
Practice Address - Zip Code:10801-5768
Practice Address - Country:US
Practice Address - Phone:914-369-1934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-04
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY330045-012084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty