About Henderson Victor Wijaya
He is located at 111050 Mount Belvedere Blvd, , in Fort Drum, NY 13602. Appointment can be made via the phone number (315) 772-6976.
Henderson Victor Wijaya - Address, Phone & Website
111050 Mount Belvedere Blvd, , Fort Drum, NY 13602
(315) 772-6976
Medical Specialties & Taxonomy codes
| Primary | Specialty | Taxonomy Code |
|---|---|---|
| Yes | Medical Physician Assistant | 363AM0700X |
| No | Other Technician | 247200000X |
| No | Physician Assistant | 363A00000X |
Licenses
| State | License Number |
|---|---|
| New York | 028353 |
| 1178843 |