Active NPI
Anthony Paul Aquino Villafuerte
- Physical Therapist
- White Haven, PA
National Provider Identifier
1558601286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT017854
- Practice address
- 22 Brookside Dr
White Haven, PA 18661-2724 - Phone
- (570) 579-6189
- NPI assigned
- Feb 16, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT017854 | PA | Primary |
Addresses
Primary practice location
22 Brookside Dr
White Haven, PA 18661-2724
Mailing address
22 Brookside Dr
White Haven, PA 18661-2724
Phone (570) 579-6189
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT017854 | PA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360972800000",
"number": "1558601286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 BROOKSIDE DR",
"city": "WHITE HAVEN",
"state": "PA",
"postal_code": "186612724",
"telephone_number": "570-579-6189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 BROOKSIDE DR",
"city": "WHITE HAVEN",
"state": "PA",
"postal_code": "186612724",
"telephone_number": "570-579-6189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLAFUERTE",
"first_name": "ANTHONY PAUL",
"middle_name": "AQUINO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-02-16",
"last_updated": "2013-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT017854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Haven, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.