Provider Demographics
NPI:1013358357
Name:DUKHOVNY, VICTORIA (ROTH)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:DUKHOVNY
Suffix:
Gender:F
Credentials:ROTH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 ROY LANE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006
Mailing Address - Country:US
Mailing Address - Phone:267-243-2502
Mailing Address - Fax:
Practice Address - Street 1:455 W STREET RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-3219
Practice Address - Country:US
Practice Address - Phone:267-243-2502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP044010L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist