Provider Demographics
NPI:1831440684
Name:VANSCOY-MCALLISTER, VICTORIA M (NPP)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:M
Last Name:VANSCOY-MCALLISTER
Suffix:
Gender:F
Credentials:NPP
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:M
Other - Last Name:VANSCOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 WOODSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12803-5632
Mailing Address - Country:US
Mailing Address - Phone:518-932-4220
Mailing Address - Fax:518-564-0029
Practice Address - Street 1:420 GLEN ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-2929
Practice Address - Country:US
Practice Address - Phone:518-502-1561
Practice Address - Fax:518-564-0029
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401464363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health