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VICTORY MEDICAL CLINIC LLC NPI 1013367465


NPI Information

NPI: 1013367465
Provider Name: VICTORY MEDICAL CLINIC LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 31D2117496

Address:
433 SAND SHORE RD
HACKETTSTOWN, NJ
ZIP 07840
Phone: (862) 254-2299
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VICTORY MEDICAL CLINIC LLC is an internal medicine in Hackettstown, NJ. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. VICTORY MEDICAL CLINIC LLC NPI is 1013367465. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

433 SAND SHORE RD
HACKETTSTOWN, NJ
ZIP 07840-504
Phone: (862) 254-2299
Fax: (862) 254-2300

The provider's authorized official is Augustine Okpala .
The authorized official title is Healthcare Professional and has the following contact phone number (862) 254-2299.

The CLIA number assigned to this NPI record is 31D2117496 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/16/2016 and was last updated on 6/16/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine25MA08035200NEW JERSEYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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