Victory Primary Care LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD073683L Issued in PA

Legal business name

VICTORY PRIMARY CARE LLC

Practice address

100 E Lancaster Ave
Med Off BLDG West Ste 432
Wynnewood, PA 19096-3450

Phone

(610) 896-7172

Fax

(610) 642-2693

NPI assigned

Jun 20, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Ann Sardanopoli, M.D.

Title

Physician

Phone

(610) 580-3794

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1466380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1679923627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 SAUNDERS DR",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "190875407",
            "telephone_number": "610-580-3794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E LANCASTER AVE",
            "address_2": "MED OFF BLDG WEST STE 432",
            "city": "WYNNEWOOD",
            "state": "PA",
            "postal_code": "190963450",
            "telephone_number": "610-896-7172",
            "fax_number": "610-642-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-20",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "SARDANOPOLI",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "610-580-3794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD073683L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David N Vegari, MD
• Teena Dein Verbit, BSN, RN,MS,CRNP
• Tanu Priya Verma, MD
• Stephen J Vernille, D.C.
• Victory Chiropractic and Performance LLC
• Oskari Pekka Johannes Vihersaari, MD
• Catherine Ann Quijano Vivo, PA
• Robin J Vogel, PA-C
• Srinivas Vommi, MD
• Jonathan Anthony Vu

• Internal Medicine Physician in Wynnewood, PA
• Providers in Wynnewood, PA by specialty
• Internal Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.