Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 225631 | NY |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 225631 | NY |
NPI | 1649200221 |
---|---|
Provider Name | Dr. Stephen J Vega |
First Address | Pittsford, NY 14534 |
Second Address | Pittsford, NY 14534 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 18/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02560878 | (05) | NY |
I11835 | (02) |