Provider Demographics
NPI:1104092071
Name:LIM, VICTOR SABRIDO
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:SABRIDO
Last Name:LIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 E 145TH STREET
Mailing Address - Street 2:JEROME BELSON HEALTH CARE CENTER
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5516
Mailing Address - Country:US
Mailing Address - Phone:718-665-7565
Mailing Address - Fax:718-665-7595
Practice Address - Street 1:245 E 145TH STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5516
Practice Address - Country:US
Practice Address - Phone:718-665-7565
Practice Address - Fax:718-665-7595
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0266261QH0100X
NY26625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service