Provider Demographics
NPI:1033186408
Name:PIROGOVSKY, VICTORIA (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:PIROGOVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:613 WARREN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2038
Mailing Address - Country:US
Mailing Address - Phone:732-974-1444
Mailing Address - Fax:
Practice Address - Street 1:613 WARREN AVE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-2038
Practice Address - Country:US
Practice Address - Phone:732-974-1444
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA070742208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8248303Medicaid
NJH17717Medicare UPIN
NJ038499Medicare ID - Type Unspecified