Healthcare Provider Details

I. General information

NPI: 1295672400
Provider Name (Legal Business Name): VICTORIA AZEVEDO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 ROCKY HILL RD
NORTHAMPTON MA
01060-4050
US

IV. Provider business mailing address

23 FORGE POND RD
GRANBY MA
01033-9754
US

V. Phone/Fax

Practice location:
  • Phone: 413-426-8463
  • Fax:
Mailing address:
  • Phone: 413-426-8463
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: