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General NPI Number Information
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NPI Number | 1891662987
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Entity Type | Organization
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Legal Business Name | 1975 VICTORY CHIROPRACTIC PC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 1975 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3553
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Country | US
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Telephone | 718-203-8518
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Fax | 718-223-5853
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Provider Business Mailing Address
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Address Line | 1975 VICTORY BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-3553
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Country | US
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Telephone | 718-203-8518
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Fax | 718-223-5853
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. MARINA GADABORSHEV
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Credential | DC
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Telephone | 973-519-6302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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