Healthcare Provider Details

I. General information

NPI: 1629431614
Provider Name (Legal Business Name): VICTORIA CHIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 03/13/2025
Certification Date: 03/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 CLINTON AVE
BROOKLYN NY
11238-6589
US

IV. Provider business mailing address

200 W 57TH ST STE 307
NEW YORK NY
10019-3211
US

V. Phone/Fax

Practice location:
  • Phone: 917-410-6905
  • Fax: 646-878-6095
Mailing address:
  • Phone: 917-410-6905
  • Fax: 646-878-6095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number268793
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number310134
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: