Provider Demographics
NPI:1487680831
Name:SOOVAJIAN, VICTORIA ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:ANN
Last Name:SOOVAJIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:ANN
Other - Last Name:NIMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:31 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:NAUGATUCK
Mailing Address - State:CT
Mailing Address - Zip Code:06770-2408
Mailing Address - Country:US
Mailing Address - Phone:203-632-5281
Mailing Address - Fax:
Practice Address - Street 1:31 SUNSET DR
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-2408
Practice Address - Country:US
Practice Address - Phone:860-262-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT032890208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics