Provider Demographics
NPI:1467847756
Name:GASIA ALFONZO, VICTOR JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JOSE
Last Name:GASIA ALFONZO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8040 PRINCETON GLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5802
Mailing Address - Country:US
Mailing Address - Phone:513-246-7000
Mailing Address - Fax:
Practice Address - Street 1:8040 PRINCETON GLENDALE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-5802
Practice Address - Country:US
Practice Address - Phone:513-246-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-02
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA310074207R00000X
OH35.140572207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine