Organization
PODIATRY SERVICES OF ITHACA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR O VILLAGONZALO DPM (PODIATRIST)
(607) 257-8877
Entity
Organization
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
213ES0131X
Foot Surgery Podiatrist
Primary
N005881
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02862408
—
NY
05
—
03034237
—
NY
01
—
3130290001
ARC
FL
Enumeration date
06/06/2008
Last updated
04/07/2020
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