Provider Demographics
NPI:1194202408
Name:ASOYA, VICTORIA NGOZI
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:NGOZI
Last Name:ASOYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LIBERTY PL APT 13
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-2793
Mailing Address - Country:US
Mailing Address - Phone:443-759-1599
Mailing Address - Fax:
Practice Address - Street 1:5403 ANNAPOLIS RD
Practice Address - Street 2:
Practice Address - City:BLADENSBURG
Practice Address - State:MD
Practice Address - Zip Code:20710-2201
Practice Address - Country:US
Practice Address - Phone:301-277-7107
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25769183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist