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Contact Information

STATEN ISLAND PHYSICIAN PRACTICE PC
441 9TH AVE
9TH FLOOR
NEW YORK, NY10001-1623
 Phone: 646-680-2894
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Dermatology

207N00000X 07 Physician/Dermatology
 

Dermatopathology

207ND0900X 07 Physician/Dermatology
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
 

MOHS-Micrographic Surgery

207ND0101X 07 Physician/Dermatology
 

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Pediatric Dermatology

207NP0225X 07 Physician/Dermatology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Procedural Dermatology

207NS0135X 07 Physician/Dermatology
 

Surgery

208600000X 02 Physician/General Surgery
 

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for STATEN ISLAND PHYSICIAN PRACTICE PC · (Female)

NPI # 1568413169
Status Active
Credentials
Entity Individual
Enumeration date 05/16/2006
Last updated 12/01/2015 - About 11 years ago
Sole proprietor 1 Not specified
Identifiers
  • NY Medicaid 02769859
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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