Provider Demographics
NPI:1578007811
Name:BARKAN, VICTORIA
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BARKAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:BARKAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9851 64TH AVE
Mailing Address - Street 2:APT 1H
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2520
Mailing Address - Country:US
Mailing Address - Phone:917-579-4966
Mailing Address - Fax:
Practice Address - Street 1:283 ADAMS ST
Practice Address - Street 2:ROOM 242- AIL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2804
Practice Address - Country:US
Practice Address - Phone:718-260-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021663235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist