Provider Demographics
NPI:1235426974
Name:DENSLOW, VICTORIA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:DENSLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3318 DOUGLAS STREET
Mailing Address - Street 2:APT 3
Mailing Address - City:PORT LEYDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13433
Mailing Address - Country:US
Mailing Address - Phone:315-348-8115
Mailing Address - Fax:
Practice Address - Street 1:3318 DOUGLAS STREET
Practice Address - Street 2:APT 3
Practice Address - City:PORT LEYDEN
Practice Address - State:NY
Practice Address - Zip Code:13433
Practice Address - Country:US
Practice Address - Phone:315-348-8115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278663-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse