Provider Demographics
NPI:1316749815
Name:VISCA, ADAM D (MD)
Entity type:Individual
Prefix:DR
First Name:ADAM
Middle Name:D
Last Name:VISCA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BLACKBIRD LN
Mailing Address - Street 2:
Mailing Address - City:SPENCERPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14559-9611
Mailing Address - Country:US
Mailing Address - Phone:585-831-1127
Mailing Address - Fax:
Practice Address - Street 1:4 BLACKBIRD LN
Practice Address - Street 2:
Practice Address - City:SPENCERPORT
Practice Address - State:NY
Practice Address - Zip Code:14559-9611
Practice Address - Country:US
Practice Address - Phone:585-831-1127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program