Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Victory Medical Group PLLC

Organization Family Medicine Physician · NPI 1912223280

Victory Medical Group PLLC is a Family Medicine Physician in Staten Island, New York. Licensed in New York. Registered with an NPI since 2010.

Licensed in
NY
In the registry since
2010
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

220 Victory Blvd
Staten Island, NY 10301-2919
Phone: (718) 447-1080
Fax: (718) 447-1559
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 255828 (NY)

Record details

NPI number1912223280
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Omar Klobocista — Medical Doctor · (347) 698-0710
NPI enumeratedApril 12, 2010
Last updated in NPPESJanuary 12, 2022
Certification dateOctober 8, 2020
Mailing address220 Victory Blvd, Staten Island, NY 10301-2919

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