NPI 1053803742

Luis Antonio Caceres Villalta, MD

Practitioner Adult Medicine Physician Corona, NY

Practice location

Address: 3716 108th St, Corona, NY 11368-2025
Phone: (718) 651-4000

Registered specialties

Adult Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QA0505X Licence 310925-01 (NY)

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Registry record

NPI: 1053803742
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 May 2018
Record last updated: 7 Jul 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.