Provider Demographics
NPI:1134460413
Name:THINNES, VICTORIA R (NP)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:R
Last Name:THINNES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:R
Other - Last Name:DOYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:181 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-2106
Mailing Address - Country:US
Mailing Address - Phone:201-310-5069
Mailing Address - Fax:
Practice Address - Street 1:127 W 25TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-7207
Practice Address - Country:US
Practice Address - Phone:212-533-4040
Practice Address - Fax:212-533-4141
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY629962163W00000X
NY401637363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse