Provider Demographics
NPI:1043077977
Name:CERNIGLIA, VICTORIA LOVE (CPHT)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LOVE
Last Name:CERNIGLIA
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 VETERANS MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2748
Mailing Address - Country:US
Mailing Address - Phone:504-835-6060
Mailing Address - Fax:504-835-0330
Practice Address - Street 1:1107 VETERANS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2748
Practice Address - Country:US
Practice Address - Phone:504-835-6060
Practice Address - Fax:504-835-0330
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA015383183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician