Provider Demographics
NPI:1437147493
Name:VIGORITA, VINCENT JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:JOHN
Last Name:VIGORITA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1845
Mailing Address - Street 2:
Mailing Address - City:AMAGANSETT
Mailing Address - State:NY
Mailing Address - Zip Code:11930-1845
Mailing Address - Country:US
Mailing Address - Phone:631-267-8726
Mailing Address - Fax:631-267-2296
Practice Address - Street 1:53 SANDPIPER LANE
Practice Address - Street 2:
Practice Address - City:AMAGANSETT
Practice Address - State:NY
Practice Address - Zip Code:11930-1845
Practice Address - Country:US
Practice Address - Phone:631-267-8726
Practice Address - Fax:631-267-2296
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY135450204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine