Provider Demographics
NPI:1326270158
Name:ACQUESTA, VICTORIA GRACE (RPA-C)
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:GRACE
Last Name:ACQUESTA
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Gender:F
Credentials:RPA-C
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Mailing Address - Street 1:1110 SOUTH AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-3403
Mailing Address - Country:US
Mailing Address - Phone:718-761-4700
Mailing Address - Fax:718-494-2767
Practice Address - Street 1:1110 SOUTH AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3403
Practice Address - Country:US
Practice Address - Phone:718-761-4700
Practice Address - Fax:718-494-2767
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-12
Last Update Date:2009-08-12
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Provider Licenses
StateLicense IDTaxonomies
NY013216363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant