MEDICARE: VICTORIA AZEVEDO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1295672400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA AZEVEDO

Provider Business Mailing Address
First Line	:	23 FORGE POND RD
Second Line	:
City	:	GRANBY
State	:	MA
Zip	:	01033-9754
Country	:	US
Telephone Number	:	413-426-8463
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 ROCKY HILL RD
Second Line	:
City	:	NORTHAMPTON
State	:	MA
Zip	:	01060-4050
Country	:	US
Telephone Number	:	413-426-8463
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/04/2026
Last Update Date	:	05/04/2026

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Directions to “ VICTORIA AZEVEDO ” Practice Location

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