Provider Demographics
NPI:1568432581
Name:LARGOZA, MARIA VICTORIA (MD)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:VICTORIA
Last Name:LARGOZA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 W SPROUL RD STE 224
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-2033
Mailing Address - Country:US
Mailing Address - Phone:610-789-6320
Mailing Address - Fax:484-471-3917
Practice Address - Street 1:100 W SPROUL RD STE 224
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-2033
Practice Address - Country:US
Practice Address - Phone:610-789-6320
Practice Address - Fax:484-471-3917
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD048949L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
508752OtherAETNA
PA0015364170001Medicaid
PA0666879000OtherIBC
0153641701OtherAMERICHOICE
02191MD048949LOtherHEALTH PARTNERS
1017039OtherKEYSTONE MERCY
390004673OtherRAILROAD MEDICARE
113479OtherHIGHMARK BLSH
113479OtherHIGHMARK BLSH
390004673OtherRAILROAD MEDICARE