Provider Demographics
NPI:1992916613
Name:VILMA JUNIO,PHYSICIAN, PLLC
Entity type:Organization
Organization Name:VILMA JUNIO,PHYSICIAN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:VILMA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-342-4217
Mailing Address - Street 1:11 4TH AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-1852
Mailing Address - Country:US
Mailing Address - Phone:315-342-4217
Mailing Address - Fax:315-342-7205
Practice Address - Street 1:11 4TH AVE
Practice Address - Street 2:SUITE C
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-1852
Practice Address - Country:US
Practice Address - Phone:315-342-4217
Practice Address - Fax:315-342-7205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233306261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care