Provider Demographics
NPI:1063032597
Name:VICTORY CLINICAL RESEARCH
Entity Type:Organization
Organization Name:VICTORY CLINICAL RESEARCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL SITE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ABIONA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-728-5004
Mailing Address - Street 1:8508 CEDAR CHASE DRIVE
Mailing Address - Street 2:VICTORY ADMIN OFFICE
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735
Mailing Address - Country:US
Mailing Address - Phone:301-728-5004
Mailing Address - Fax:
Practice Address - Street 1:7212 HANOVER PARKWAY
Practice Address - Street 2:SUITE A
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770
Practice Address - Country:US
Practice Address - Phone:301-441-1704
Practice Address - Fax:301-441-1851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-24
Last Update Date:2020-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Single Specialty