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Individual

VICTORIA SUMMER ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1613 ROUTE 47 UNIT G, RIO GRANDE, NJ 08242
(609) 886-5245
(609) 886-5873
Mailing address
1613 ROUTE 47 UNIT G, RIO GRANDE, NJ 08242-1411
(609) 886-5245
(609) 886-5873

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA10581300
NJ
207Q00000X
Family Medicine Physician
MD453908
PA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
05/17/2012
Last updated
07/02/2019
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