Healthcare Provider Details

I. General information

NPI: 1255583373
Provider Name (Legal Business Name): VIKTORIYA LAZNIK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

948 48TH ST FL 2
BROOKLYN NY
11219-2918
US

IV. Provider business mailing address

2375 E 3RD ST APT 2P
BROOKLYN NY
11223-5321
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-7670
  • Fax:
Mailing address:
  • Phone: 347-350-3171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number335728
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NR24786900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: