Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mark Joseph Villanueva Gamboa

Individual provider Physical Therapist · NPI 1619374980

Mark Joseph Villanueva Gamboa is a Physical Therapist in St Johnsville, New York. Licensed in Connecticut. Registered with an NPI since 2014.

Licensed in
CT
In the registry since
2014
Specialties on file
2
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Practice location Address checks out

7 Timmerman Ave
St Johnsville, NY 13452-1017
Phone: (518) 568-5037
Fax: (518) 568-7505
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 10430 (CT)
Physical Therapist Taxonomy 225100000X

Record details

NPI number1619374980
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedDecember 2, 2014
Last updated in NPPESJune 15, 2017

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