Victory Medical Pllc
LBN: Victory Medical Pllc
Victory Medical Pllc is an health care organization with primary practice located at 2372 Victory Blvd , Staten Island NY 10314-6607. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery of the Hand. Allopathic & Osteopathic Physicians / Plastic Surgery is the primary health care specialty.
Victory Medical Pllc can be contacted via phone (718) 761-3700, or through Lacqua, Michael Jude via phone (718) 761-3700.
Contact Information
Primary practice address
2372 Victory Blvd
Staten Island NY 10314-6607
Phone: (718) 761-3700
Fax: (718) 698-3090
Website:
Authorized official contact:
Name: Lacqua, Michael Jude Doctor of Medicine (MD)
Phone: (718) 761-3700
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 192446 | New York |
| Allopathic & Osteopathic Physicians / Surgery of the Hand | 2086S0105X | 192446 | New York |
Profile Details
| NPI number | 1013348689 |
|---|---|
| LBN Legal business name | Victory Medical Pllc |
| DBA Doing business as | |
| Authorized official | Lacqua, Michael Jude Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Dec 9th, 2013 |
| Last updated | Apr 9th, 2015 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013348689 | NPPES |
| New York | Other | 1992753883 | NPI |
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