Provider Demographics
NPI:1497990774
Name:AGARONNIK, VIKTORIA (PT)
Entity Type:Individual
Prefix:MS
First Name:VIKTORIA
Middle Name:
Last Name:AGARONNIK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:VIKTORIA
Other - Middle Name:
Other - Last Name:LOPUKHIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1851 E 18TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2914
Mailing Address - Country:US
Mailing Address - Phone:718-382-7763
Mailing Address - Fax:718-382-7763
Practice Address - Street 1:1851 E 18TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2914
Practice Address - Country:US
Practice Address - Phone:718-382-7763
Practice Address - Fax:718-382-7763
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-15
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0139552251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics