Provider Demographics
NPI:1811666068
Name:BAYRON, VICTORIA (LPN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:BAYRON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HUTCHINS ST
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-3607
Mailing Address - Country:US
Mailing Address - Phone:716-361-5717
Mailing Address - Fax:
Practice Address - Street 1:109 HUTCHINS ST
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-3607
Practice Address - Country:US
Practice Address - Phone:716-361-5717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
NY305407164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No251E00000XAgenciesHome Health