Individual
DOMENICO VITERBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1375 WASHINGTON AVE STE 101, ALBANY, NY 12206-1056
(518) 438-4483
Mailing address
111 CLOCK TOWER CMNS, BREWSTER, NY 10509-4055
(845) 592-4915
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
283724-1
NY
207RG0100X
Gastroenterology Physician
Q3826
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
283724-1
LICENSE
NY
Enumeration date
05/05/2009
Last updated
07/21/2022
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