Provider Demographics
NPI:1568523033
Name:WEISS, VICTORIA MOLNAR (OD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:MOLNAR
Last Name:WEISS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CENTRE COURT
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:VA
Mailing Address - Zip Code:22963-2329
Mailing Address - Country:US
Mailing Address - Phone:434-591-0262
Mailing Address - Fax:434-591-0111
Practice Address - Street 1:5 CENTRE COURT
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:VA
Practice Address - Zip Code:22963-2329
Practice Address - Country:US
Practice Address - Phone:434-591-0262
Practice Address - Fax:434-591-0111
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2014-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000665152W00000X
NYTUV0050421152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA219842OtherANTHEM
VA9233229Medicaid
VA146815OtherSOUTHERN HEALTH
VA264200OtherANTHEM
VA9234306Medicaid
U13435Medicare UPIN
VA410000996Medicare PIN
VA9234306Medicaid