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Organization
VICTORY MEDICAL GROUP PLLC
Active
Organization
VICTORY MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OMAR KLOBOCISTA MD (MEDICAL DOCTOR)
(347) 698-0710
Entity
Organization
Contact information
Practice address
220 VICTORY BLVD, STATEN ISLAND, NY 10301-2919
(718) 447-1080
(718) 447-1559
Mailing address
220 VICTORY BLVD, STATEN ISLAND, NY 10301-2919
(718) 447-1080
(718) 447-1559
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
255828
NY
Other
Enumeration date
04/12/2010
Last updated
01/12/2022
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