NPI 1013348689

Victory Medical PLLC

Organisation Plastic Surgery Physician Staten Island, NY

Practice location

Address: 2372 Victory Blvd, Staten Island, NY 10314-6607
Phone: (718) 761-3700
Fax: (718) 698-3090

Authorised official

Name: Michael Jude Lacqua
Title: Medical Doctor
Phone: (718) 761-3700

Registered specialties (2)

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X Licence 192446 (NY)

Other Plastic Surgery providers in New York →

Surgery of the Hand (Surgery) Physician

Allopathic & Osteopathic Physicians Taxonomy 2086S0105X Licence 192446 (NY)

Other Surgery providers in New York →

Registry record

NPI: 1013348689
Entity type: Organization
NPI issued: 9 Dec 2013
Record last updated: 9 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.