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NPI Code Detail

MEDICARE: VICTORIA WHITAKER PA-C

MEDICARE:   VICTORIA  WHITAKER  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant23.007373CT

General Provider Information

NPI Number : 1003675224
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA WHITAKER PA-C
Provider Business Mailing Address
First Line : 179 GRISWOLD RD
Second Line :
City : WETHERSFIELD
State : CT
Zip : 06109-3624
Country : US
Telephone Number : 860-559-4471
Fax Number :
Provider Business Practice Location Address
First Line : 80 SEYMOUR ST
Second Line :
City : HARTFORD
State : CT
Zip : 06106-3300
Country : US
Telephone Number : 860-545-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2024
Last Update Date : 12/11/2025

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Directions to “ VICTORIA WHITAKER PA-C” Practice Location

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