Healthcare Provider Details

I. General information

NPI: 1235104076
Provider Name (Legal Business Name): VICTORIA MARIE REESMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA MARIE KYRIAKOU NP

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 05/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6010 BAY PKWY STE 901
BROOKLYN NY
11204-6081
US

IV. Provider business mailing address

530 1ST AVE SUITE 5D
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 718-238-2100
  • Fax: 718-748-0863
Mailing address:
  • Phone: 212-263-3491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number301797
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number301797
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: