Provider Demographics
NPI:1235236266
Name:MALCHAR, VICTORIA ELIZABETH (DC)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ELIZABETH
Last Name:MALCHAR
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 COLLEGE HILL ROAD
Mailing Address - Street 2:BUILDING 30C
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886
Mailing Address - Country:US
Mailing Address - Phone:401-826-7600
Mailing Address - Fax:401-822-7879
Practice Address - Street 1:33 COLLEGE HILL ROAD
Practice Address - Street 2:BUILDING 30C
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886
Practice Address - Country:US
Practice Address - Phone:401-826-7600
Practice Address - Fax:401-822-7879
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDC00269111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIDC00269OtherLICENSE
41161OtherCOMMERCIAL
359003501Medicare ID - Type Unspecified
35011Medicare UPIN