Provider Demographics
NPI:1821845348
Name:ROMAN, VICTORIA ELISABETH
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ELISABETH
Last Name:ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ELISABETH
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 293
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10542-0293
Mailing Address - Country:US
Mailing Address - Phone:914-260-6367
Mailing Address - Fax:
Practice Address - Street 1:223 MAIN ST # 103
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2770
Practice Address - Country:US
Practice Address - Phone:914-260-6367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker