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General NPI Number Information
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NPI Number | 1982034823
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Entity Type | Individual
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Provider Name | VICTORIA LYN EMBREY-MITCHELL PHYSICIAN ASSISTANT
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Gender | Female
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Dates
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Enumeration Date | 11/13/2013
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 295 MADISON AVE FL 12 OFFICE OF DR. WENDY WOLFSON, DO
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City | NEW YORK
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State | NY
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Zip | 10017-2049
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Country | US
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Telephone | 917-499-8250
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Fax | 917-591-1420
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Provider Business Mailing Address
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Address Line | 2 POST OFFICE RD UNIT 113
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City | WACCABUC
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State | NY
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Zip | 10597-7508
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Country | US
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Telephone | 917-499-8250
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Fax | 917-591-1420
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 6317
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00835400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 017210
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License Number State | NY
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