Provider Demographics
NPI:1447648753
Name:PHILLIPS, VICTORIA I (PHD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:I
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 W 65TH ST APT 5D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-6639
Mailing Address - Country:US
Mailing Address - Phone:914-505-7933
Mailing Address - Fax:
Practice Address - Street 1:10 W 65TH ST APT 5D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-6639
Practice Address - Country:US
Practice Address - Phone:914-505-7933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent