Provider Demographics
NPI:1891275376
Name:WEISER, VICTORIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:WEISER
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 1:9117 SESUIT LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-6107
Mailing Address - Country:US
Mailing Address - Phone:804-306-6788
Mailing Address - Fax:
Practice Address - Street 1:4591 S LABURNUM AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23231-2421
Practice Address - Country:US
Practice Address - Phone:804-591-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202216107183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist