Individual
DR. MARIO FRANCISCO VICTORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18969 US ROUTE 11, 5699 OUTER WASHINGTON STREET, WATERTOWN, NY 13601-5320
(315) 782-4391
(315) 788-8319
Mailing address
PO BOX 6600, 18969 US ROUTE 11, WATERTOWN, NY 13601-6600
(315) 782-4391
(315) 788-8319
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
208358
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01900196
—
NY
Enumeration date
05/12/2006
Last updated
03/13/2013
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