Provider Demographics
NPI:1689760795
Name:VILLANUEVA, HUGO J (MD)
Entity type:Individual
Prefix:DR
First Name:HUGO
Middle Name:J
Last Name:VILLANUEVA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-9239
Mailing Address - Country:US
Mailing Address - Phone:914-636-8591
Mailing Address - Fax:914-633-5084
Practice Address - Street 1:4141 CARPENTER AVE
Practice Address - Street 2:RENAL UNIT
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2600
Practice Address - Country:US
Practice Address - Phone:718-920-9041
Practice Address - Fax:718-920-9043
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY211742207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7X3671OtherBLUE CROSS
211742OtherHIP
NY01948145Medicaid
NYF65658Medicare UPIN
211742OtherHIP