1437678000 NPI number — VICTORIA ANNE VEGUERIA MA, BCABA

Table of content: VICTORIA ANNE VEGUERIA MA, BCABA (NPI 1437678000)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437678000 NPI number — VICTORIA ANNE VEGUERIA MA, BCABA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VEGUERIA
Provider First Name:
VICTORIA
Provider Middle Name:
ANNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, BCABA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RAMBADT
Provider Other First Name:
VICTORIA
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437678000
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1353 E MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROWNSBURG
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46112-1433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
317-520-4748
Provider Business Mailing Address Fax Number:
813-337-0937

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1353 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROWNSBURG
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
317-520-4748
Provider Business Practice Location Address Fax Number:
813-337-0937
Provider Enumeration Date:
09/14/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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