Provider Demographics
NPI:1811697436
Name:FURLETTI, VICTORIA LYNN (LPN)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:LYNN
Last Name:FURLETTI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:MS
Other - First Name:VICTORIA
Other - Middle Name:LYNN
Other - Last Name:COSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7580 STATE ROUTE 104A
Mailing Address - Street 2:
Mailing Address - City:RED CREEK
Mailing Address - State:NY
Mailing Address - Zip Code:13143-9524
Mailing Address - Country:US
Mailing Address - Phone:315-236-6826
Mailing Address - Fax:
Practice Address - Street 1:7580 STATE ROUTE 104A
Practice Address - Street 2:
Practice Address - City:RED CREEK
Practice Address - State:NY
Practice Address - Zip Code:13143-9524
Practice Address - Country:US
Practice Address - Phone:315-236-6826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY320041164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse