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1053803742
LUIS ANTONIO CACERES VILLALTA
CORONA, NY
NPI
1053803742
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207QA0505X Family Medicine, Adult Medicine
(Licence: NY 310925-01)
Enumeration Date
2018-05-30
Last Update Date
2021-07-07
Business Address
Mr. LUIS ANTONIO CACERES VILLALTA M.D.
3716 108TH ST
CORONA, NY 11368-2025
Phone number: 718-651-4000
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Mailing Address
Mr. LUIS ANTONIO CACERES VILLALTA M.D.
3716 108TH ST
CORONA, NY 11368-2025
Phone number: 718-651-4000
Copy
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