VICTORY MEDICINE PC (NPI# 1730331141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730331141 |
| Entity Type | Organization |
| Organization Name | VICTORY MEDICINE PC |
| Practice Address |
25 Victory Blvd 2nd Floor Staten Island NY 10301-2905 |
| Practice Telephone | 7188157246 |
| Practice Fax Number | 5167061085 |
| Mailing Telephone | 7188157246 |
| Mailing Fax Number | 5167061085 |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2008-10-16 |
| Authorized Official Name | DR. DEPIKA BAJAJ (DIRECTOR) |
| Authorized Official Telephone | 9178152299 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0008X |
Psychiatry & Neurology Specialization: Neuromuscular Medicine |
148054 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
25 VICTORY BLVD 2ND FLOOR |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10301-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518133107 | Bindhu Sree Kakarala | Physical Therapist | 25 Victory Blvd, 2nd Floor, Staten Island, NY 10301-2905 | 2008-05-02 |
| 1093960676 | Advanced Multicare Medical PC | Physical Medicine & Rehabilitation | 25 Victory Blvd, 2nd Floor, Staten Island, NY 10301-2905 | 2008-11-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417586397 | Maria Duncan | Registered Nurse | Nurse Family Partnership, 358 St. Marks Place, 5th Floor, Staten Island, NY 10301 | 2020-04-03 |
| 1659835569 | Ipark Podiatry P.C. | Podiatrist | 970 Bard Avenue, Staten Island, NY 10301 | 2019-01-24 |
| 1386149789 | Dana Gioia | Specialist | 215 Hart Blvd Apt 5a, Staten Island, NY 10301 | 2018-03-27 |
| 1710404850 | Physical Therapy Unlimited | Preferred Provider Organization | 684 Ocean Terrace, Staten Island, NY 10301 | 2017-08-29 |
| 1356885438 | Jessica Glassman | Social Worker | 10 Dobbs Pl, Staten Island, NY 10301 | 2016-12-08 |
| 1679016372 | Amelia Rella | Speech-Language Pathologist | 60 Foote Ave, Staten Island, NY 10301 | 2016-11-29 |
| 1457714958 | Philip Kaplan | Dentist | 155 Bay Street, Unit C3, Staten Island, NY 10301 | 2016-04-01 |
| 1104284777 | Marie G Joseph | Social Worker | 2381 Hyland Blvd, Staten Island, NY 10301 | 2016-02-10 |
| 1700262565 | Courtney Pryor | Speech-Language Pathologist | 57 Westbury Avenue, Staten Island, NY 10301 | 2015-08-04 |
| 1710377999 | Jessica Maldarelli | Speech-Language Pathologist | 91 Henderson Avenue, Staten Island, NY 10301 | 2015-01-27 |
| Find all providers in zip 10301 | ||||
| Taxonomy Code | 2084N0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neuromuscular Medicine |
| A neurologist or child neurologist who specializes in the diagnosis and management of disorders of nerve, muscle or neuromuscular junction, including amyotrophic lateral sclerosis, peripheral neuropathies (e.g., diabetic and immune mediated neuropathies), various muscular dystrophies, congenital and acquired myopathies, inflammatory myopathies (e.g., polymyositis, inclusion body myositis) and neuromuscular transmission disorders (e.g., myasthenia gravis, Lambert-Eaton myasthenic syndrome). |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: new] Additional Resources: American Board of Psychiatry and Neurology, 2007. http://www.abpn.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Psychiatry and Neurology |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255773149 | Thurman Wheeler | Psychiatry & Neurology | 601 Elmwood Ave., Box 645, Rochester, NY 14642 | 2013-07-22 |
| 1518234145 | Glenwood Medical PC | Psychiatry & Neurology | 11572 Francis Lewis Blvd, Cambria Heights, NY 11411-1028 | 2011-11-28 |
| 1043549108 | Sujata Prakash Thawani | Psychiatry & Neurology | 222 E 41st St Fl 9, New York, NY 10017-6739 | 2009-12-18 |
| 1326208166 | Anna Kogan | Psychiatry & Neurology | 333 Greene Ave, Brooklyn, NY 11238 | 2008-06-16 |
| 1669891677 | Robin Warner | Psychiatry & Neurology | 332 E 14th St, New York, NY 10003-4243 | 2014-04-08 |
| 1033537311 | Phillip C Mongiovi | Psychiatry & Neurology | 601 Elmwood Ave, Box Med, Rochester, NY 14642-0001 | 2014-04-02 |
| 1477822138 | Pambo Medical Neuro-rehabilitation PC | Psychiatry & Neurology | 930 Grand Concourse, Suite 1j, Bronx, NY 10451-2705 | 2011-12-23 |
| 1215224266 | Ikjae Lee | Psychiatry & Neurology | 710 W 168th St # Ni-3, New York, NY 10032-3726 | 2011-06-28 |
| 1457523789 | David Sternman, Md, PC | Psychiatry & Neurology | 30 West 60th Street, Suite An, New York, NY 10023 | 2008-03-27 |
| 1154503571 | Neurologic Consultations Md PC | Psychiatry & Neurology | 354 E 76th St, New York, NY 10021-2505 | 2007-11-27 |
| Find all providers with the same taxonomy | ||||
| City | STATEN ISLAND |
| Zip Code | 10301 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.