Basic Information
| Provider Information | |||||||||
| NPI: | 1366012247 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VITO C. QUATELA, MD, VICTOR MEDICAL, PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 973 EAST AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146072216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852693688 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7255 STATE ROUTE 96 | ||||||||
| Address2: | |||||||||
| City: | VICTOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145649009 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852441000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/01/2021 | ||||||||
| LastUpdateDate: | 07/01/2021 | ||||||||
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| AuthorizedOfficialLastName: | STINARDO | ||||||||
| AuthorizedOfficialFirstName: | DENISE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 5852693621 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/29/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RS0010X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sports Medicine |
No ID Information.