Provider Demographics
NPI:1154159606
Name:ESOWE, VICTOR
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:ESOWE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 APPLEGATE ROAD SUITE 100 #1123
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STOUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360
Mailing Address - Country:US
Mailing Address - Phone:646-498-9436
Mailing Address - Fax:
Practice Address - Street 1:205 APPLEGATE ROAD SUITE 100 #1123
Practice Address - Street 2:SUITE 100
Practice Address - City:STOUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360
Practice Address - Country:US
Practice Address - Phone:646-498-9436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-25
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist