260 WEST 73RD STREET, NEW YORK, 10023, NEW YORK
| Entity Name | EDWIN X. VICIOSO. M.D. P.C. |
| Entity Number | 4000680 |
| Status | ACTIVE |
| Incorporation Date | 28th September 2010 |
| Dos Process Address | 41 CHATSWORTH AVENUE, LARCHMONT, 10538, NEW YORK |
| Jurisdiction | NEW YORK |
| County | WESTCHESTER |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |