Provider Demographics
NPI:1699535161
Name:BANGAREE, VICTORIA ASHLEY
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ASHLEY
Last Name:BANGAREE
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 1:8944 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-2246
Mailing Address - Country:US
Mailing Address - Phone:917-618-4141
Mailing Address - Fax:
Practice Address - Street 1:10235 64TH RD UNIT GF
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1545
Practice Address - Country:US
Practice Address - Phone:347-837-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-20
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18-P127611-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health