Organization
BAKER VICTORY HEALTHCARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERESE M. SCOFIDIO (CHIEF EXECUTIVE OFFICER)
(716) 828-9515
Entity
Organization
Contact information
Practice address
790 RIDGE ROAD, LACKAWANNA, NY 14218-1696
(716) 828-9350
(716) 828-9355
Mailing address
790 RIDGE ROAD, LACKAWANNA, NY 14218-1696
(716) 828-9350
(716) 828-9355
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1402201R
NY
122300000X
Dentist
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01899518
—
NY
Enumeration date
04/12/2007
Last updated
10/30/2015
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