MEDICARE: VICTOR SAMUEL STANTON

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	163WG0000X	General Practice Registered Nurse	812133	NY

General Provider Information

NPI Number	:	1497687586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR SAMUEL STANTON

Provider Business Mailing Address
First Line	:	521 BERGEN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-4010
Country	:	US
Telephone Number	:	914-364-8967
Fax Number	:	718-742-7321

Provider Business Practice Location Address
First Line	:	521 BERGEN AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10455-4010
Country	:	US
Telephone Number	:	914-364-8967
Fax Number	:	718-742-7321

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

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ VICTOR SAMUEL STANTON ” Practice Location

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