Individual
DR. EDWIN XAVIER VICIOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
12/11/2008
Last updated
06/26/2013
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