Individual
DR. JOHN D VICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3330 VETERANS MEMORIAL HWY, SUITE9, BOHEMIA, NY 11716-1036
(631) 285-6789
(631) 285-7105
Mailing address
3330 VETERANS MEMORIAL HWY, SUITE9, BOHEMIA, NY 11716-1036
(631) 285-6789
(631) 285-7105
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
198664
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01899265
—
NY
Enumeration date
03/12/2007
Last updated
07/08/2007
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