Victory Physical Therapy, P.C.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

010846 Issued in NY

Legal business name

VICTORY PHYSICAL THERAPY, P.C.

Practice address

2550 Victory Blvd
Suite 301
Staten Island, NY 10314-6635

Phone

(718) 761-0017

Fax

(718) 761-6980

NPI assigned

Apr 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Diane Carol Ryan, PT

Title

President

Phone

(718) 761-0017

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kishore Kanduri

  • Physical Therapist
  • Howard Beach, NY
  • NPI 1740226281
  Medicare reassignment NPD
• Jothsna Med Kacharam

  • Physical Therapist
  • Middletown, NY
  • NPI 1487477907
  NPD
• Manish Reddy Dabbi

  • Physical Therapist
  • Staten Island, NY
  • NPI 1760350862
  NPD (past)
• Lori A Chesnock, PT, MS

  • Physical Therapist
  • Clark, NJ
  • NPI 1265630503
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659595254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 VICTORY BLVD",
            "address_2": "SUITE 301",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146635",
            "telephone_number": "718-761-0017",
            "fax_number": "718-761-6980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 VICTORY BLVD",
            "address_2": "SUITE 301",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146635",
            "telephone_number": "718-761-0017",
            "fax_number": "718-761-6980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY PHYSICAL THERAPY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-761-0017",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "010846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Medical PLLC
• Victory Medical Services PLLC
• Victory Medical Supplies Inc
• Victory Medicine PC
• Victory Obstetrics & Gynecology PC
• Victory Podiatry Associate PLLC
• Victory RX LLC
• Victory RX Pharma Inc
• Victoryendoscopyunit,PLLC
• Michele Ann Vigeant, LMHC

• Physical Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.