Provider Demographics
NPI:1962299438
Name:ENDOW, VICTORIA (MPH RDN CDN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:ENDOW
Suffix:
Gender:
Credentials:MPH RDN CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 SAINT FELIX ST FL 11
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3032
Mailing Address - Country:US
Mailing Address - Phone:718-250-8981
Mailing Address - Fax:
Practice Address - Street 1:86 SAINT FELIX ST FL 11
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3032
Practice Address - Country:US
Practice Address - Phone:718-250-8981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012417133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered