Provider Demographics
NPI:1326094673
Name:MANFREDI, VICTORIA E (MD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:E
Last Name:MANFREDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 65028-MERIVALE
Mailing Address - Street 2:NEPEAN
Mailing Address - City:OTTAWA
Mailing Address - State:ON
Mailing Address - Zip Code:K2G5Y3
Mailing Address - Country:CA
Mailing Address - Phone:613-596-9840
Mailing Address - Fax:
Practice Address - Street 1:ACCESS MEDICAL CENTER
Practice Address - Street 2:2525 CARLING AVENUE
Practice Address - City:OTTAWA
Practice Address - State:ON
Practice Address - Zip Code:K2B7Z2
Practice Address - Country:CA
Practice Address - Phone:613-596-9840
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158998207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine