STATEN ISLAND MEDICAL OF NEW YORK, LLC (NPI# 1669864369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669864369 |
| Entity Type | Organization |
| Organization Name | STATEN ISLAND MEDICAL OF NEW YORK, LLC |
| Practice Address |
1975 Hylan Blvd Ste C Staten Island NY 10306 |
| Mailing Address |
4141 Dundee Rd Northbrook IL 60062-2129 |
| Practice Telephone | 8473053346 |
| Practice Fax Number | 8889796720 |
| Mailing Telephone | 8472571244 |
| Mailing Fax Number | 2242468042 |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2018-05-24 |
| Authorized Official Name | YAN KATSNELSON (DIRECTOR) |
| Authorized Official Telephone | 8472571244 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
1975 HYLAN BLVD STE C |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134737372 | Nancy Burns | Counselor | 345 Guyon Ave # 14, Staten Island, NY 10306 | 2020-07-14 |
| 1710537642 | Happy Island Senior Center LLC | Clinic/Center | 555 Greeley Ave, Staten Island, NY 10306 | 2019-09-12 |
| 1215580055 | Keann Pender | Counselor | 345 Guyon Ave Rm 14, Staten Island, NY 10306 | 2019-07-22 |
| 1346751435 | Amanda Nicole Lewis | Speech-Language Pathologist | 465 New Dorp Lane, The Richard H. Hungerford School, Staten Island, NY 10306 | 2017-10-17 |
| 1649793142 | Olympia Services Inc | Radiology | 1913 Olympia Blvd., Staten Island, NY 10306 | 2017-07-18 |
| 1265961601 | A & S Educational Technology Inc. | Early Intervention Provider Agency | 99 Sydney Pl, Staten Island, NY 10306 | 2017-06-08 |
| 1124489638 | Prospect Kids, LLC | Early Intervention Provider Agency | 21 Kayla Court, Staten Island, NY 10306 | 2016-03-10 |
| 1124498407 | Tatyana Kateva | Registered Nurse | 1975 Hylan Blvd Suite 1, Staten Island, NY 10306 | 2015-09-30 |
| 1336536275 | Natallia Verbitsky | Occupational Therapist | 165 Twombly Ave, Staten Island, NY 10306 | 2015-04-17 |
| 1922491745 | Evan Ross Cohen | Dentist | 1975 Hylan Blvd., Unit #2, Hylan Dental Arts, Staten Island, NY 10306 | 2015-03-18 |
| Find all providers in zip 10306 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285812180 | Saqib Zia | Surgery | 501 Seaview Ave Ste 302, Staten Island, NY 10305-3419 | 2008-02-04 |
| 1841255254 | Staten Island Vein Treatment & Practice Pllc | Surgery | 449 Medina St, Unit Id, Staten Island, NY 10306 | 2006-04-19 |
| 1023089141 | Maria Fodera | Surgery | 2235 Clove Rd, Staten Island, NY 10305 | 2006-01-27 |
| 1205815727 | Christos Dean Dossa | Surgery | 2460 Hylan Blvd, Staten Island, NY 10306-3117 | 2006-01-12 |
| 1679550578 | Frank Tarantini | Surgery | 2025 Richmond Ave, Suite 1ll, Staten Island, NY 10314-3937 | 2005-12-30 |
| 1669888277 | Staten Island Medical of New York LLC | Surgery | 1975 Hylan Blvd, Staten Island, NY 10306 | 2014-07-02 |
| 1598064669 | Kuldeep Singh | Surgery | 501 Seaview Ave, Suite 302, Staten Island, NY 10305-3419 | 2011-03-15 |
| 1558450312 | Laser and Varicose Vein Treatment Center of Staten Island | Surgery | 500 Seaview Ave, Ste 240, Staten Island, NY 10305-3403 | 2006-10-12 |
| 1801850920 | Gary Giangola | Surgery | 256 Mason Ave, Building B 2nd Floor, Staten Island, NY 10305-3408 | 2006-04-14 |
| 1275505042 | New York Surgical Assoc PC | Surgery | 2235 Clove Rd, Staten Island, NY 10305 | 2006-02-06 |
| Find all providers in STATEN ISLAND | ||||
| City | STATEN ISLAND |
| Zip Code | 10306 |
Please comment or provide details below to improve the information on STATEN ISLAND MEDICAL OF NEW YORK, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.