Provider Demographics
NPI:1629217898
Name:PLAN, VICTRINA RILLERA (NP)
Entity type:Individual
Prefix:MS
First Name:VICTRINA
Middle Name:RILLERA
Last Name:PLAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:VICTRINA
Other - Middle Name:ORPILLA
Other - Last Name:RILLERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:6 KATHRYN PL
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1520
Mailing Address - Country:US
Mailing Address - Phone:201-384-5936
Mailing Address - Fax:
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:PH-1-137
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304989-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health