Provider Demographics
NPI:1942409149
Name:SHARP, VICTORIA
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:SHARP
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:DIMONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3366 BOSTON RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-2451
Mailing Address - Country:US
Mailing Address - Phone:786-547-4222
Mailing Address - Fax:718-653-4636
Practice Address - Street 1:3366 BOSTON RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-2451
Practice Address - Country:US
Practice Address - Phone:786-547-4222
Practice Address - Fax:718-653-4636
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT15239225100000X
NY032969171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist