Provider Demographics
NPI:1073792115
Name:FILIPPI BACKUS, VICTORIA M (FNP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:M
Last Name:FILIPPI BACKUS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 BEACH 129TH ST
Mailing Address - Street 2:
Mailing Address - City:BELLE HARBOR
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1516
Mailing Address - Country:US
Mailing Address - Phone:718-318-3434
Mailing Address - Fax:718-318-3723
Practice Address - Street 1:431 BEACH 129TH ST
Practice Address - Street 2:
Practice Address - City:BELLE HARBOR
Practice Address - State:NY
Practice Address - Zip Code:11694-1516
Practice Address - Country:US
Practice Address - Phone:718-318-3434
Practice Address - Fax:718-318-3723
Is Sole Proprietor?:No
Enumeration Date:2007-10-25
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332969363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02079830Medicaid
NY81037HMedicare PIN