Organization
VICTORY FAMILY WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARISSA JEROMINOW AGPCNP (OWNER)
(347) 443-3707
Entity
Organization
Contact information
Practice address
1812 QUENTIN RD STE M2, BROOKLYN, NY 11229-1336
(347) 443-3707
(917) 791-9110
Mailing address
1812 QUENTIN RD STE M2, BROOKLYN, NY 11229-1336
(347) 443-3707
(917) 791-9110
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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