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Individual

MR. JEFFERY JASON VIRGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTC, OPA-C, LSA

Contact information

Practice address
234 E 149TH ST, BRONX, NY 10451-5504
(718) 579-5919
(718) 579-4620
Mailing address
703 MALLARD WAY, PEEKSKILL, NY 10566-4178
(914) 737-5608

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
246ZX2200X
Orthopedic Assistant
Primary
O000066-
NY

Other

Enumeration date
02/24/2006
Last updated
02/02/2023
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