Provider Demographics
NPI:1336450923
Name:RATTIGAN, VICTORIA M (SLP)
Entity Type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:M
Last Name:RATTIGAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CLOVER AVE
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-2533
Mailing Address - Country:US
Mailing Address - Phone:516-326-7420
Mailing Address - Fax:
Practice Address - Street 1:54 CLOVER AVE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2533
Practice Address - Country:US
Practice Address - Phone:516-326-7420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005926-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist