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NPI Code Detail

MEDICARE: DR. FERDINAND VISCO M.D.

MEDICARE: DR. FERDINAND VISCO M.D.
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
1207RC0000XCardiovascular Disease Physician113869-1NY

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 : 1124010822
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FERDINAND VISCO M.D.
Provider Business Mailing Address
First Line : 70 EUCLID RD
Second Line :
City : FORT LEE
State : NJ
Zip : 07024-6434
Country : US
Telephone Number : 201-886-8511
Fax Number :
Provider Business Practice Location Address
First Line : 90-02 QUEENS BLVD
Second Line : ST. JOHN'S QUEENS HOSPITAL
City : ELMHURST
State : NY
Zip : 11373-4941
Country : US
Telephone Number : 718-558-1830
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2005
Last Update Date : 07/08/2007

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