MEDICARE: MISS VICTORIA RADZINSKI LMT

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
1	225700000X	Massage Therapist	18KT00600100	NJ

General Provider Information

NPI Number	:	1639843170
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS VICTORIA RADZINSKI LMT

Provider Business Mailing Address
First Line	:	631 HACKENSACK ST
Second Line	:
City	:	CARLSTADT
State	:	NJ
Zip	:	07072-1307
Country	:	US
Telephone Number	:	201-551-7154
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 RIVER ST STE 3D
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-5619
Country	:	US
Telephone Number	:	201-551-7154
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2021
Last Update Date	:	08/08/2021

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Directions to “ MISS VICTORIA RADZINSKI LMT” Practice Location

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