Individual
VICTOR VICENTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1155 BROADWAY, FIRST FLOOR, BROOKLYN, NY 11221-3025
(718) 249-0735
Mailing address
1155 BROADWAY, FIRST FLOOR, BROOKLYN, NY 11221-3025
(718) 249-0735
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
191197
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01599297
—
NY
Enumeration date
03/29/2007
Last updated
02/20/2012
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