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Individual
DR. VINCENT GUY DESIDERIO JR.
Active
Individual
DR. VINCENT GUY DESIDERIO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
12007
DC
Other
Enumeration date
12/15/2005
Last updated
02/14/2008
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