Individual
DR. AGNES VIDA QUEBRAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 RIDGE RD, STE 130, WEST SENECA, NY 14224-3332
(716) 675-0707
(716) 961-3706
Mailing address
1900 RIDGE RD, STE 130, WEST SENECA, NY 14224-3332
(716) 675-0707
(716) 961-3706
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
250185
NY
207R00000X
Internal Medicine Physician
MD063195L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001973682
—
PA
05
—
3038671
—
NY
Enumeration date
12/12/2006
Last updated
10/19/2012
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