Provider Demographics
NPI:1689445892
Name:LEFEVRE, VICTORIA T I
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:T
Last Name:LEFEVRE
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 FREMONT ST
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-6109
Mailing Address - Country:US
Mailing Address - Phone:973-905-9608
Mailing Address - Fax:
Practice Address - Street 1:119 SCHENECTADY AVE FL 3
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-2330
Practice Address - Country:US
Practice Address - Phone:347-915-1112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator