Individual
MARIA TERESA DE LA VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9 MINER ST, CANTON, NY 13617-1208
(315) 386-8821
(315) 386-4732
Mailing address
9 MINER ST, CANTON, NY 13617-1208
(315) 386-8821
(315) 386-4732
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F300013-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00583697
—
NY
Enumeration date
02/13/2007
Last updated
03/07/2023
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