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

Victory Medical PLLC

Organization Plastic Surgery Physician · NPI 1922845007

Victory Medical PLLC is a Plastic Surgery Physician in Staten Island, New York. Registered with an NPI since 2024.

In the registry since
2024
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

2372 Victory Blvd
Staten Island, NY 10314-6607
Phone: (781) 761-3700
Fax: (718) 698-3090
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1922845007
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Lacqua — Owner · (781) 761-3700
NPI enumeratedJuly 15, 2024
Last updated in NPPESJuly 15, 2024
Certification dateJuly 15, 2024
Mailing address2372 Victory Blvd, Staten Island, NY 10314-6607

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