Provider Demographics
NPI:1821971862
Name:HERRERA, VICTOR (FNP)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:HERRERA
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:VICTOR
Other - Middle Name:
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:230 HALSTED RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1116
Mailing Address - Country:US
Mailing Address - Phone:908-397-9268
Mailing Address - Fax:
Practice Address - Street 1:230 HALSTED RD
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-1116
Practice Address - Country:US
Practice Address - Phone:908-397-9268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR21159500363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty