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General NPI Number Information
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NPI Number | 1396866679
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Entity Type | Individual
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Provider Name | VICTORIA C. DEMOS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 03/18/2022
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Provider Practice Location Address
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Address Line | 300 MERCER ST APT 3L
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City | NEW YORK
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State | NY
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Zip | 10003-6732
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Country | US
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Telephone | 917-406-2456
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Fax |
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Provider Business Mailing Address
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Address Line | 1559 POST RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-5933
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Country | US
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Telephone | 917-406-2456
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 010570-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 003325
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License Number State | CT
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