National Provider Identifier Database

STATEN ISLAND MEDICAL OF NEW YORK LLC
Vascular Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.


Contact Information

STATEN ISLAND MEDICAL OF NEW YORK, LLC
1975 HYLAN BLVD STE C
STATEN ISLAND, NY10306
Phone: 847-305-3346
Fax: 888-979-6720
Website:
Specialty Taxonomy Code
* Vascular Surgery 2086S0129X

* Indicates primary specialty

NPI Profile & details for STATEN ISLAND MEDICAL OF NEW YORK, LLC

NPI Number 1669864369
Legal business name
LBN
STATEN ISLAND MEDICAL OF NEW YORK, LLC
Authorized official YAN KATSNELSON - (DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 03/04/2015
Last updated 05/24/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers n/a

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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