Organization
EDWIN X VICIOSO M D P C
Active
Organization
EDWIN X VICIOSO M D P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN XAVIER VICIOSO MD (OWNER)
(914) 409-5211
Entity
Organization
Contact information
Practice address
16 GUION PL, SOUND SHORE MEDICAL CENTER ANESTHESIA DEPARTMENT, NEW ROCHELLE, NY 10801-5502
(914) 409-5211
Mailing address
PO BOX 270, MASSAPEQUA PARK, NY 11762-0270
(631) 264-2035
(631) 264-1418
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
250531
NY
Other
Enumeration date
02/07/2012
Last updated
06/19/2013
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