Provider Demographics
NPI:1912037813
Name:O'CONNOR, VICTORIA M (PT)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:M
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:6065 MANLIUS TOWNLINE RD
Mailing Address - Street 2:
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9525
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:522 WESTCOTT ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2549
Practice Address - Country:US
Practice Address - Phone:315-478-0463
Practice Address - Fax:315-476-9757
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY020845-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist