Provider Demographics
NPI:1235566068
Name:VICTORY MEDICAL CARE PC
Entity Type:Organization
Organization Name:VICTORY MEDICAL CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLOT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-880-1884
Mailing Address - Street 1:9229 QUEENS BLVD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1056
Mailing Address - Country:US
Mailing Address - Phone:347-880-1884
Mailing Address - Fax:800-646-5901
Practice Address - Street 1:9229 QUEENS BLVD
Practice Address - Street 2:SUITE 2A
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1056
Practice Address - Country:US
Practice Address - Phone:347-880-1884
Practice Address - Fax:800-646-5901
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-12
Last Update Date:2013-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty