Individual provider · Type 1 NPI

Bryan Mauricio Villalta

Licensed Practical Nurse · Brentwood, NY

NPI number 1184529992 Active

Practice location

5 Clarke St
Brentwood, NY 11717-2001

Call (631) 624-8610 Map

Specialties and licenses

TaxonomyCodeLicense
Licensed Practical Nurse Primary 164W00000X358175 (NY)

Licensed Practical Nurse: An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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About NPI 1184529992

Bryan Mauricio Villalta's National Provider Identifier is 1184529992, issued on Oct 12, 2026. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Brentwood, NY. The record was last updated on Oct 12, 2026.