Provider Demographics
NPI:1558522268
Name:VACANTI, VICTOR JUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:JUDE
Last Name:VACANTI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:333 INTERNATIONAL DR
Mailing Address - Street 2:SUITE B3
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5726
Mailing Address - Country:US
Mailing Address - Phone:716-458-0268
Mailing Address - Fax:716-428-3822
Practice Address - Street 1:333 INTERNATIONAL DR
Practice Address - Street 2:SUITE B3
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5726
Practice Address - Country:US
Practice Address - Phone:716-458-0268
Practice Address - Fax:716-428-3822
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2016-08-06
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Provider Licenses
StateLicense IDTaxonomies
NY261739207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine