Healthcare Provider Details

I. General information

NPI: 1053870659
Provider Name (Legal Business Name): VICTORIA MINIOR MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2019
Last Update Date: 03/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 E 60TH ST STE 1902
NEW YORK NY
10022-1008
US

IV. Provider business mailing address

30 E 60TH ST STE 1902
NEW YORK NY
10022-1008
US

V. Phone/Fax

Practice location:
  • Phone: 646-453-4240
  • Fax: 646-453-4240
Mailing address:
  • Phone: 646-453-4240
  • Fax: 646-453-4240

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: VICTORIA MINIOR
Title or Position: OWNER
Credential: MD
Phone: 646-453-4240