NPIMap

Organization Active NPI

Victory Medicine PC

  • Neuromuscular Medicine (Psychiatry & Neurology) Physician
  • Staten Island, NY
National Provider Identifier
1730331141
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromuscular Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084N0008X
License
148054 Issued in NY
Legal business name
VICTORY MEDICINE PC
Practice address
25 Victory Blvd
2ND Floor
Staten Island, NY 10301-2905
Phone
(718) 815-7246
Fax
(516) 706-1085
NPI assigned
Oct 16, 2008
Last updated
Oct 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Authorized official

Name
Dr. Depika Bajaj, MD
Title
Director
Phone
(917) 815-2299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 148054 NY Primary

Addresses

Primary practice location

25 Victory Blvd
2ND Floor
Staten Island, NY 10301-2905

Mailing address

25 Victory Blvd
2ND Floor
Staten Island, NY 10301-2905
Phone (718) 815-7246

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1730331141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 VICTORY BLVD",
            "address_2": "2ND FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012905",
            "telephone_number": "718-815-7246",
            "fax_number": "516-706-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 VICTORY BLVD",
            "address_2": "2ND FLOOR",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012905",
            "telephone_number": "718-815-7246",
            "fax_number": "516-706-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTORY MEDICINE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "BAJAJ",
        "authorized_official_first_name": "DEPIKA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "917-815-2299",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "NY",
            "license": "148054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.