| Doctor Name: | MR. ANTHONY AUGUST VISCO |
| NPI Number: | 1043593601 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | L.M.S.W. |
| License Number: | 056958 |
| Business Practice Address: | 1010 Center Rd East Aurora, NY - 140523009 |
| Business Phone Number: | 7166528250 |
| Business Fax Number: | 7166553675 |
| Mailing Address: | 1010 Center Rd, EAST AURORA |
| State: | NY |
| Postal Code: | 140523009 |
| Phone Number: | 7166528250 |
| Fax Number: | 7166553675 |
| NPI Enumeration Date: | 09/21/2011 |
| NPI Last Update Date: | 09/21/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041S0200X |
| License Number: | 056958 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |