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OIG exclusion detail

VICTOR VIDAL

This page shows an imported LEIE row. Verify details against the official OIG source before acting.

Imported OIG rowOfficial OIG source
NPI
0000000000
Name
VICTOR MANUEL SR VIDAL
Address
201 RICES MILL ROAD, WYNCOTE, PA, 19095
Specialty
MENTAL/BEHAVIORAL HE
Exclusion type
1128b7
Exclusion date
20191231
Reinstatement date
00000000
Waiver
00000000

Source snapshot

Imported: May 05, 2026

Rows: 83,001

Checksum: 3a10b8ee0e4691855f74ce65a5e733672474291f79ed1f7cef163328d945e9a7

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