Provider Demographics
NPI:1659503662
Name:BARBERER, VICTORIA LYNN (LPN, RN)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LYNN
Last Name:BARBERER
Suffix:
Gender:F
Credentials:LPN, RN
Other - Prefix:
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Mailing Address - Street 1:PO BOX 118
Mailing Address - Street 2:
Mailing Address - City:MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11955-0118
Mailing Address - Country:US
Mailing Address - Phone:631-828-8738
Mailing Address - Fax:631-828-8738
Practice Address - Street 1:57 PIEDMONT DR
Practice Address - Street 2:APARTMENT #131B
Practice Address - City:PORT JEFFERSON STATION
Practice Address - State:NY
Practice Address - Zip Code:11776-1125
Practice Address - Country:US
Practice Address - Phone:631-828-8738
Practice Address - Fax:631-828-8738
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY618903163W00000X, 163WP0200X
NY264944164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No164W00000XNursing Service ProvidersLicensed Practical Nurse