Provider Demographics
NPI:1609325901
Name:COMERCHERO, VICTORIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:COMERCHERO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 E 81ST ST
Mailing Address - Street 2:2F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4005
Mailing Address - Country:US
Mailing Address - Phone:917-250-9485
Mailing Address - Fax:
Practice Address - Street 1:345 E 81ST ST
Practice Address - Street 2:2F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4005
Practice Address - Country:US
Practice Address - Phone:917-250-9485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018949103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool