Healthcare Provider Details

I. General information

NPI: 1477981108
Provider Name (Legal Business Name): VICTORIA MERAUTI ADAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA MERAUTI

II. Dates (important events)

Enumeration Date: 10/15/2013
Last Update Date: 01/19/2022
Certification Date: 07/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 34TH ST
BROOKLYN NY
11232-2014
US

IV. Provider business mailing address

594 DEAN ST
BROOKLYN NY
11238-3009
US

V. Phone/Fax

Practice location:
  • Phone: 929-379-3913
  • Fax:
Mailing address:
  • Phone: 800-475-6168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number338350
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: