Provider Demographics
NPI:1093103749
Name:LIOTTA, VICTORIA ANGELA (DAC, LAC, LMT)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ANGELA
Last Name:LIOTTA
Suffix:
Gender:F
Credentials:DAC, LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HAZELWOOD PL
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4273
Mailing Address - Country:US
Mailing Address - Phone:516-353-2341
Mailing Address - Fax:
Practice Address - Street 1:11 STEWART AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2738
Practice Address - Country:US
Practice Address - Phone:631-421-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-05
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020509225700000X
NY005103171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist