MEDICARE: VICTORIA PHYSICAL MEDICINE PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician		NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639243751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VICTORIA PHYSICAL MEDICINE PC

Provider Business Mailing Address
First Line	:	53 ELIZABETH ST
Second Line	:	SUITE 3A
City	:	NEW YORK
State	:	NY
Zip	:	10013-4623
Country	:	US
Telephone Number	:	212-966-9818
Fax Number	:	212-966-9189

Provider Business Practice Location Address
First Line	:	53 ELIZABETH ST
Second Line	:	SUITE 3A
City	:	NEW YORK
State	:	NY
Zip	:	10013-4623
Country	:	US
Telephone Number	:	212-966-9818
Fax Number	:	212-966-9189

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VICTORIA ZHANG
Credential	:	DO
Telephone Number	:	212-966-9818

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	12/16/2014

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