Provider Demographics
NPI:1326509548
Name:CUOMO, VICTORIA ANNE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:ANNE
Last Name:CUOMO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 OLDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1442
Mailing Address - Country:US
Mailing Address - Phone:516-528-0681
Mailing Address - Fax:
Practice Address - Street 1:2200 NORTHERN BLVD STE 212
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1220
Practice Address - Country:US
Practice Address - Phone:516-253-5106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY342296363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily