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General NPI Number Information
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NPI Number | 1023398278
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Entity Type | Organization
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Legal Business Name | STEPHEN J VEGA MD PLLC
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Dates
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Enumeration Date | 08/19/2011
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Last Update Date | 08/19/2011
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Provider Practice Location Address
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Address Line | 1050 PITTSFORD VICTOR RD BLDG B
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City | PITTSFORD
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State | NY
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Zip | 14534-3812
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Country | US
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Telephone | 585-383-4040
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Fax | 585-383-4051
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Provider Business Mailing Address
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Address Line | 1050 PITTSFORD VICTOR RD BLDG B
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City | PITTSFORD
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State | NY
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Zip | 14534-3812
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Country | US
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Telephone | 585-383-4040
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Fax | 585-383-4051
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Authorized Official
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Title or Position | DOCTOR, OWNER
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Name | STEPHEN J VEGA
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Credential | MD
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Telephone | 585-383-4040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 225631
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License Number State | NY
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