Individual
DR. JESSE MARTIN VICTORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(718) 630-7000
Mailing address
515 83RD ST FL 1, BROOKLYN, NY 11209-4503
(917) 588-2907
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
293987
NY
2086S0102X
Surgical Critical Care Physician
293987
NY
2086S0127X
Trauma Surgery Physician
293987
NY
Other
Enumeration date
04/18/2013
Last updated
12/26/2021
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