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NPI Code Detail

MEDICARE: VICTORYA FOGEL M.S., L.N.S.

MEDICARE: VICTORYA FOGEL M.S., L.N.S.
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
1133N00000XNutritionist005150NY

General Provider Information

NPI Number : 1760687578
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORYA FOGEL M.S., L.N.S.
Provider Business Mailing Address
First Line : 2610 E 18TH ST
Second Line : SUITE 4
City : BROOKLYN
State : NY
Zip : 11235-3622
Country : US
Telephone Number : 718-332-0080
Fax Number : 718-332-3365
Provider Business Practice Location Address
First Line : 2610 E 18TH ST
Second Line : SUITE 4
City : BROOKLYN
State : NY
Zip : 11235-3622
Country : US
Telephone Number : 718-332-0080
Fax Number : 718-332-3365
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2007
Last Update Date : 07/08/2007

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