Healthcare Provider Details

I. General information

NPI: 1770519290
Provider Name (Legal Business Name): EMERGENCY MEDICINE PHYSICIANS OF STATEN ISLAND, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 BARD AVE EMERGENCY DEPARTMENT
STATEN ISLAND NY
10310-1664
US

IV. Provider business mailing address

355 BARD AVE EMERGENCY DEPARTMENT
STATEN ISLAND NY
10310-1664
US

V. Phone/Fax

Practice location:
  • Phone: 718-818-2055
  • Fax: 212-356-4608
Mailing address:
  • Phone: 718-818-2055
  • Fax: 212-356-4608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. EDWARD ADRIAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 718-818-2055