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General NPI Number Information
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NPI Number | 1114822400
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Entity Type | Organization
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Legal Business Name | VICTORY MEDICAL OF MARYLAND PC
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 19 HILLTOP PL
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City | MONSEY
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State | NY
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Zip | 10952-2809
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Country | US
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Telephone | 917-599-9655
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Fax |
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Provider Business Mailing Address
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Address Line | 19 HILLTOP PL
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City | MONSEY
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State | NY
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Zip | 10952-2809
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RICHARD DANIELS
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Credential | MD
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Telephone | 732-598-4226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State | NULL
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