Provider Demographics
NPI:1912239864
Name:TUBIS, VICTORIA (PHARM D)
Entity Type:Individual
Prefix:MISS
First Name:VICTORIA
Middle Name:
Last Name:TUBIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 KENT AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-3103
Mailing Address - Country:US
Mailing Address - Phone:718-302-1549
Mailing Address - Fax:
Practice Address - Street 1:164 KENT AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-3103
Practice Address - Country:US
Practice Address - Phone:718-302-1549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist