Provider Demographics
NPI:1801066675
Name:MAGERSKI, VI L (BS/BC/HIS)
Entity type:Individual
Prefix:MRS
First Name:VI
Middle Name:L
Last Name:MAGERSKI
Suffix:
Gender:F
Credentials:BS/BC/HIS
Other - Prefix:MRS
Other - First Name:VI
Other - Middle Name:L
Other - Last Name:MAGERSKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BS/BC/HIS
Mailing Address - Street 1:1912 45TH STREET - EASTWOOD MALL
Mailing Address - Street 2:THE HEARING PLACE
Mailing Address - City:MUNSTER
Mailing Address - State:IN
Mailing Address - Zip Code:46321
Mailing Address - Country:US
Mailing Address - Phone:219-922-8710
Mailing Address - Fax:
Practice Address - Street 1:1912 45TH AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-3917
Practice Address - Country:US
Practice Address - Phone:219-922-8710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17000846174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist