Provider Demographics
NPI:1609609460
Name:ZYSK, VICTORIA ANNA (AUD)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANNA
Last Name:ZYSK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:291 CULVER ST
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-5114
Mailing Address - Country:US
Mailing Address - Phone:860-712-3986
Mailing Address - Fax:
Practice Address - Street 1:22 TOMPKINS ST STE 1
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-1496
Practice Address - Country:US
Practice Address - Phone:203-754-5141
Practice Address - Fax:203-236-0181
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000782237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter