Provider Demographics
NPI:1326083189
Name:BIDA, VICTORIA (RPA C)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BIDA
Suffix:
Gender:F
Credentials:RPA C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 DAVIES AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14586-8804
Mailing Address - Country:US
Mailing Address - Phone:585-747-5736
Mailing Address - Fax:
Practice Address - Street 1:110 SCIENCE PKWY
Practice Address - Street 2:UNIVERSITY IMAGING AT SCIENCE PARK
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4251
Practice Address - Country:US
Practice Address - Phone:585-785-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006181363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02366452Medicaid
P76122Medicare UPIN
DD3815Medicare ID - Type Unspecified
NY02366452Medicaid