Individual
ALFIN G VICENCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 PROSPECT AVE, WFAN 3RD FLOOR, HACKENSACK, NJ 07601-1915
(551) 996-5207
Mailing address
331 NEWMAN SPRINGS RD, BLDG 2, STE 220, RED BANK, NJ 07701-5688
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
212630
NY
2080P0214X
Pediatric Pulmonology Physician
212630
NY
2080P0214X
Pediatric Pulmonology Physician
Primary
25MA12296500
NJ
Other
Enumeration date
10/31/2006
Last updated
06/04/2025
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