Provider Demographics
NPI:1982121992
Name:HICKMAN, VICTORIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:HICKMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:WRONSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6616 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14094-6109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6616 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:NY
Practice Address - Zip Code:14094-6109
Practice Address - Country:US
Practice Address - Phone:716-438-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY063387183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist