Healthcare Provider Details

I. General information

NPI: 1003148107
Provider Name (Legal Business Name): VICTORIA JOSIFOVSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2010
Last Update Date: 02/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

391 KEARNY AVE
KEARNY NJ
07032-2603
US

IV. Provider business mailing address

391 KEARNY AVE
KEARNY NJ
07032-2603
US

V. Phone/Fax

Practice location:
  • Phone: 201-246-8077
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: