Individual
DR. GEORGE ROBERT VITO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
8745 LAKE STREET RD, LE ROY, NY 14482
(585) 297-9761
(585) 672-9100
Mailing address
45 SUMMIT ST, LE ROY, NY 14482-1530
(585) 797-5828
(158) 567-2910
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
330
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
N005120
NY
213ES0103X
Foot & Ankle Surgery Podiatrist
SC004333
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03157146
—
NY
05
—
5917998
—
NC
01
—
J300533759
MEDICARE PTAN
NY
Enumeration date
02/02/2006
Last updated
08/19/2019
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