Provider Demographics
NPI:1346767068
Name:ARD, VICTORIA A (PT, DPT, ATC, LAT)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:A
Last Name:ARD
Suffix:
Gender:F
Credentials:PT, DPT, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 MONTAUK ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1606
Mailing Address - Country:US
Mailing Address - Phone:1203-551-1559
Mailing Address - Fax:
Practice Address - Street 1:2 OVERHILL RD STE 315
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-5316
Practice Address - Country:US
Practice Address - Phone:914-723-6987
Practice Address - Fax:914-723-7546
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0033682255A2300X
CT0010042255A2300X
NY041756225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer