Provider Demographics
NPI:1659658722
Name:LEAMAN, VICTORIA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:LEAMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 ROUTE 72 W STE G
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2821
Mailing Address - Country:US
Mailing Address - Phone:609-704-6800
Mailing Address - Fax:609-704-6801
Practice Address - Street 1:517 ROUTE 72 W STE G
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2821
Practice Address - Country:US
Practice Address - Phone:609-704-6800
Practice Address - Fax:609-704-6801
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03294400183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist