MRS. Mary Theresa Vickers

NPI #1578824694 in Putnam Valley, New York

Provider Information

NPI Number: 1578824694
Entity Type: Individual
Name: MRS. Mary Theresa Vickers
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Jun 5, 2012
Last Updated: Jun 6, 2012

Practice Location

Address: 6 FLORENCE RD
City: Putnam Valley
State: New York
ZIP Code: 10579-3422
Phone: (914) 433-6791

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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