Provider Demographics
NPI:1881162188
Name:VANECH, VICTORIA (CLC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:VANECH
Suffix:
Gender:F
Credentials:CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 SOUND BEACH AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:OLD GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06870-1626
Mailing Address - Country:US
Mailing Address - Phone:203-869-6994
Mailing Address - Fax:
Practice Address - Street 1:276 SOUND BEACH AVE FL 2
Practice Address - Street 2:
Practice Address - City:OLD GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06870-1626
Practice Address - Country:US
Practice Address - Phone:203-869-6994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN