Healthcare Provider Details

I. General information

NPI: 1073383956
Provider Name (Legal Business Name): VICTORIA LEIGH ZAGURSKY LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA LEIGH PULEO LSW

II. Dates (important events)

Enumeration Date: 01/03/2024
Last Update Date: 01/03/2024
Certification Date: 01/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MINE ST
FLEMINGTON NJ
08822-6500
US

IV. Provider business mailing address

24 TRADESVILLE DR
DOYLESTOWN PA
18901-2990
US

V. Phone/Fax

Practice location:
  • Phone: 609-257-2667
  • Fax:
Mailing address:
  • Phone: 908-705-7699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06912800
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW140874
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: