Healthcare Provider Details

I. General information

NPI: 1750977542
Provider Name (Legal Business Name): VICTORIA SALOKAS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 12/15/2020
Certification Date: 12/15/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WATER ST
NEWTON NJ
07860-1420
US

IV. Provider business mailing address

PO BOX 58
LAYTON NJ
07851-0058
US

V. Phone/Fax

Practice location:
  • Phone: 973-579-1119
  • Fax:
Mailing address:
  • Phone: 973-219-9547
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number28RI02633200
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02633200
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: