DR. JORGE OCTAVIO VILLELLA III


Address: 1 Trescott Path, Northport, NY 11768-2535
Phone: 6312922404

DR. JORGE OCTAVIO VILLELLA III (NPI# 1992042766) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992042766
Entity Type Individual
Full Name DR. JORGE OCTAVIO VILLELLA III
Practice Address 1 Trescott Path
Northport
NY 11768-2535
Practice Telephone 6312922404
Mailing Telephone 6312922404
Enumeration Date 2013-01-13
Last Update Date 2013-01-13
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YP2500X Counselor
Specialization: Professional
121894 NY Behavioral Health & Social Service Providers

Office Location

Street Address 1 TRESCOTT PATH
City NORTHPORT
State NY
Zip Code 11768-2535

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Taxonomy Information

Taxonomy Code 101YP2500X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Professional

Taxonomy Definition

Definition to come...

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1649456831 Harvey A Edwards Iv Counselor 3665 Watermelon Road, Northport, AL 35473 2008-01-17
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1730107947 John Thorington Counselor 5906 6th Ave, Northport, AL 35473-7437 2006-07-17
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Competitor

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City NORTHPORT
Zip Code 11768

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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