Provider Demographics
NPI:1679133417
Name:MASILANG, VICTORIA (FNP)
Entity Type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:
Last Name:MASILANG
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9318 209TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11428-1048
Mailing Address - Country:US
Mailing Address - Phone:347-241-2028
Mailing Address - Fax:
Practice Address - Street 1:739 KNICKERBOCKER AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-5336
Practice Address - Country:US
Practice Address - Phone:718-456-1900
Practice Address - Fax:718-456-8709
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF350857363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily