Provider Demographics
NPI:1164773016
Name:RIES, VICTORIA ROSE (OD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ROSE
Last Name:RIES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:360 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1863
Mailing Address - Country:US
Mailing Address - Phone:215-757-6200
Mailing Address - Fax:215-750-7875
Practice Address - Street 1:360 MIDDLETOWN BLVD STE 402
Practice Address - Street 2:
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1863
Practice Address - Country:US
Practice Address - Phone:215-757-6200
Practice Address - Fax:215-750-7875
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2017-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ270A00647100152W00000X
PAOEG002694152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist