Provider Demographics
NPI:1770842361
Name:FORTE, VICTORIA MARION (RPH)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:MARION
Last Name:FORTE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1720
Mailing Address - Country:US
Mailing Address - Phone:347-228-8262
Mailing Address - Fax:
Practice Address - Street 1:359 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1720
Practice Address - Country:US
Practice Address - Phone:347-228-8262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-16
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046615183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist