Provider Demographics
NPI:1811376148
Name:VINOKUR, VIKTORIYA
Entity Type:Individual
Prefix:
First Name:VIKTORIYA
Middle Name:
Last Name:VINOKUR
Suffix:
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 1:672 PRISCILLA PL
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-1122
Mailing Address - Country:US
Mailing Address - Phone:646-265-0356
Mailing Address - Fax:
Practice Address - Street 1:672 PRISCILLA PL
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-1122
Practice Address - Country:US
Practice Address - Phone:646-265-0356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025938235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist