Individual
MS. VICTORIA CATHERINE VALLEJO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11 MERIDIAN RD, EATONTOWN, NJ 07724-2242
(732) 663-0300
(732) 663-0301
Mailing address
11 MERIDIAN RD, EATONTOWN, NJ 07724-2242
(732) 663-0300
(732) 663-0301
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015871
NY
363A00000X
Physician Assistant
Primary
25MP00464400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015871
STATE LICENSE
NY
01
—
25MP00464400
STATE LICENSE
NJ
Enumeration date
08/10/2012
Last updated
04/19/2018
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