Provider Demographics
NPI:1619188307
Name:MOHAMMED, VICTORIA ELAINE (CRT)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:ELAINE
Last Name:MOHAMMED
Suffix:
Gender:F
Credentials:CRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E 104TH ST
Mailing Address - Street 2:APT#203-A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-5501
Mailing Address - Country:US
Mailing Address - Phone:917-583-5405
Mailing Address - Fax:
Practice Address - Street 1:325 E 104TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-5501
Practice Address - Country:US
Practice Address - Phone:917-583-5405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0023334-1227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified