Provider Demographics
NPI:1972678092
Name:GOLDHAMMER, VICTORIA J (OTR)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:J
Last Name:GOLDHAMMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 ACKER PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-5212
Mailing Address - Country:US
Mailing Address - Phone:202-321-8173
Mailing Address - Fax:
Practice Address - Street 1:662 ACKER PL NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-5212
Practice Address - Country:US
Practice Address - Phone:202-321-8173
Practice Address - Fax:202-544-4304
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT100000123225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC277821Medicare PIN