Provider Demographics
NPI:1629304837
Name:GOLDFELD, VICTORIA (RN)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:GOLDFELD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 CLIFTON AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2723
Mailing Address - Country:US
Mailing Address - Phone:201-474-8063
Mailing Address - Fax:201-905-8050
Practice Address - Street 1:930 CLIFTON AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2723
Practice Address - Country:US
Practice Address - Phone:201-474-8063
Practice Address - Fax:201-905-8050
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-22
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0116100251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHP0116100Medicaid
NJ0219690Medicaid