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General NPI Number Information
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NPI Number | 1982530671
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Entity Type | Individual
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Provider Name | DERRICK VICTORINO PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 06/20/2026
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Last Update Date | 06/20/2026
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Provider Practice Location Address
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Address Line | 5840 POST RD
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City | EAST GREENWICH
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State | RI
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Zip | 02818-2140
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Country | US
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Telephone | 401-398-7933
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Fax | 401-329-0001
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Provider Business Mailing Address
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Address Line | 14 KANE ST
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City | NEW BEDFORD
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State | MA
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Zip | 02740-3124
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Country | US
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Telephone | 774-305-0538
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Fax | 774-305-0538
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | APRN05222
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License Number State | RI
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