Individual
PHILIP DOMINIC VITTICORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 FORT HILL AVE, CANANDAIGUA, NY 14424-1159
(585) 393-7293
(585) 393-8375
Mailing address
400 FORT HILL AVE, CANANDAIGUA, NY 14424-1159
(585) 393-7293
(585) 393-8375
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
237427
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RB8229
MEDICARE PTAN
NY
Enumeration date
08/12/2006
Last updated
06/01/2021
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