Healthcare Provider Details

I. General information

NPI: 1669319190
Provider Name (Legal Business Name): VICTORIA SARFO MENSAH AGACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2336 GRAND CONCOURSE
BRONX NY
10458-6903
US

IV. Provider business mailing address

3438 GRACE AVE
BRONX NY
10469-2612
US

V. Phone/Fax

Practice location:
  • Phone: 718-220-0439
  • Fax: 719-933-2914
Mailing address:
  • Phone: 718-220-0439
  • Fax: 719-933-2914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberF433476
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: