Healthcare Provider Details

I. General information

NPI: 1104764919
Provider Name (Legal Business Name): VICTORIA MCDERMOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VOCTORIA BONDI

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 FIREMENS WAY
POUGHKEEPSIE NY
12603-6519
US

IV. Provider business mailing address

1468 ROUTE 82
HOPEWELL JUNCTION NY
12533-3314
US

V. Phone/Fax

Practice location:
  • Phone: 845-452-9220
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number008927
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: