Healthcare Provider Details

I. General information

NPI: 1982196705
Provider Name (Legal Business Name): VICTORIA VALLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VICTORIA CONNORS

II. Dates (important events)

Enumeration Date: 06/06/2018
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 OLD COUNTRY RD STE C103N
WESTBURY NY
11590-5156
US

IV. Provider business mailing address

311 DUCKPOND DR S
WANTAGH NY
11793-1856
US

V. Phone/Fax

Practice location:
  • Phone: 516-806-6969
  • Fax:
Mailing address:
  • Phone: 516-965-7945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: