Active NPI
Maria C Villaquiran, MD
- Pediatrics Physician
- Newark, NJ
National Provider Identifier
1669497707
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MA08010600
- Practice address
- 101 Ludlow St
Newark, NJ 07114-1108 - Phone
- (973) 565-0355
- Fax
- (973) 565-0461
- NPI assigned
- Jul 12, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MA08010600 | NJ | Primary |
Addresses
Primary practice location
101 Ludlow St
Newark, NJ 07114-1108
Mailing address
139 Rock Creek Dr
Clifton, NJ 07014-2024
Phone (973) 472-6677
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0111325 | Medicaid | NJ | |
| 1740345693 | Other | NJ | 741 BROADWAY |
| 1972778413 | Other | NJ | 1150 SPRINGFIELD AVE |
| 1932370483 | Other | NJ | 101 LUDLOW STREET |
| 1235300799 | Other | NJ | 37 N DAY |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA08010600 | NJ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212969600000",
"number": "1669497707",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 ROCK CREEK DR",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070142024",
"telephone_number": "973-472-6677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 LUDLOW ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071141108",
"telephone_number": "973-565-0355",
"fax_number": "973-565-0461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VILLAQUIRAN",
"first_name": "MARIA",
"middle_name": "C",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-12",
"last_updated": "2008-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NJ",
"license": "MA08010600",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0111325",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "741 BROADWAY",
"identifier": "1740345693",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1150 SPRINGFIELD AVE",
"identifier": "1972778413",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "101 LUDLOW STREET",
"identifier": "1932370483",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "37 N DAY",
"identifier": "1235300799",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.