Basic Information
| Provider Information | |||||||||
| NPI: | 1851380844 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NUGENT | ||||||||
| FirstName: | VICTORIA | ||||||||
| MiddleName: | UBERTI | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 KINGS HWY S | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146175504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5859221900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 360 LINDEN OAKS | ||||||||
| Address2: | SUITE #300 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146252806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853838830 | ||||||||
| FaxNumber: | 5853838901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2005 | ||||||||
| LastUpdateDate: | 05/10/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | F300574 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 02507817 | 05 | NY | MEDICAID | P00075502 | 01 | MEDICARE TRAVELERS | OTHER |