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NPI Code Detail

MEDICARE: DR. JUAN ANGEL VEGA MD

MEDICARE: DR. JUAN ANGEL VEGA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianJ9837TX
2208000000XPediatrics Physician238612NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073545984
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JUAN ANGEL VEGA MD
Provider Business Mailing Address
First Line : 800 RED MILLS RD
Second Line :
City : WALLKILL
State : NY
Zip : 12589-3220
Country : US
Telephone Number : 845-744-9105
Fax Number : 845-744-9107
Provider Business Practice Location Address
First Line : 800 RED MILLS RD
Second Line :
City : WALLKILL
State : NY
Zip : 12589-3220
Country : US
Telephone Number : 845-744-9105
Fax Number : 845-744-9107
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/08/2021

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