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General NPI Number Information
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NPI Number | 1003888298
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Entity Type | Individual
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Provider Name | GEORGE ROBERT VITO D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 8745 LAKE STREET RD
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City | LE ROY
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State | NY
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Zip | 14482
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Country | US
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Telephone | 585-297-9761
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Fax | 585-672-9100
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Provider Business Mailing Address
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Address Line | 45 SUMMIT ST
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City | LE ROY
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State | NY
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Zip | 14482-1530
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Country | US
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Telephone | 585-797-5828
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Fax | 158-567-2910
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 330
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC004333
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | N005120
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License Number State | NY
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