Organization · NPI-2

1975 Victory Chiropractic PC

Clinic/Center, Medical Specialty · Staten Island, NY

NPI number1891662987
StatusActive
Last updated in NPPESOct 22, 2025

Details

NPI
1891662987
Entity type
Organization (NPI-2)
Legal business name
1975 Victory Chiropractic PC
Organization subpart
No
Enumeration date
Oct 22, 2025
Certification date
Oct 22, 2025
Last updated
Oct 22, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM2500X Clinic/Center, Medical Specialty––Yes
261QP3300X Clinic/Center, Pain––

Practice location

1975 Victory Blvd
Staten Island, NY 10314-3553

Phone 718-203-8518 · Fax 718-223-5853

Mailing address

1975 Victory Blvd
Staten Island, NY 10314-3553

Phone 718-203-8518 · Fax 718-223-5853

Authorized official

Marina Gadaborshev
Chiropractor/Owner
9735196302

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