Provider Demographics
NPI:1275139099
Name:HUH, VICTORIA JEAN
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:JEAN
Last Name:HUH
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 1:194 W BROOKLINE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1285
Mailing Address - Country:US
Mailing Address - Phone:516-320-3023
Mailing Address - Fax:
Practice Address - Street 1:874 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4005
Practice Address - Country:US
Practice Address - Phone:617-442-0309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH239110183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist