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Individual

DR. JEFFREY J VISCO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4955 N BAILEY AVE, SUITE 205, AMHERST, NY 14226
(716) 857-8751
(716) 961-2225
Mailing address
425 ESSJAY RD STE 170, WILLIAMSVILLE, NY 14221-5782
(716) 630-1219
(716) 817-1726

Taxonomy

Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
229881-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00026906501
UNIVERA
NY
01
000527799001
HEALTH NOW
NY
01
1412674
IHA
NY
01
161000580
EMPIRE PLAN
NY
05
2588374
NY
Enumeration date
01/11/2006
Last updated
08/22/2018
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