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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK JOSEPH VILLANUEVA GAMBOA

Active

MARK JOSEPH VILLANUEVA GAMBOA is a Physical Therapy Assistant healthcare provider located in ST JOHNSVILLE, New York. NPI 1619374980 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · ST JOHNSVILLE, NY

Registration Details

NPI Number
1619374980
Provider Type
Individual
Gender
Male
NPI Issued
Dec 2, 2014 (11.714598086046 yrs)
Last Updated
Jun 15, 2017
License
10430 (CT)

Practice Information

Address
7 TIMMERMAN AVE
ST JOHNSVILLE, NY, 134521017
Browse NY providers · Browse ZIP 13452
Phone
5185685037
Fax
5185687505
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in ST JOHNSVILLE, NY

Name Credential NPI
JERRY A BUSHEY PT 1053373563
MRS. RACHAEL ANN FAULKNER DPT 1518226125
RICHARD WHITE DPT 1326433384
SHRUTI SHARMA 1710401062
EMILY CHRISMAN 1487133153
REBECCA WOROBEY 1578272688
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.