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Individual

DR. VICTOR VILLAGONZALO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
2255 N TRIPHAMMER RD, ITHACA, NY 14850-1576
(607) 257-8877
(607) 257-8879
Mailing address
2255 N TRIPHAMMER RD, ITHACA, NY 14850-1576
(607) 257-8877
(607) 257-8879

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000992
GA
213E00000X
Podiatrist
Primary
N005881
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02862408
NY
Enumeration date
01/17/2006
Last updated
06/28/2013
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