Provider Demographics
NPI:1538465133
Name:IGE, VICTORIA A
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:A
Last Name:IGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 HENDRIX ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-9103
Mailing Address - Country:US
Mailing Address - Phone:718-940-2588
Mailing Address - Fax:
Practice Address - Street 1:1051 HENDRIX ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-9103
Practice Address - Country:US
Practice Address - Phone:718-940-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303553-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse