Healthcare Provider Details

I. General information

NPI: 1124047378
Provider Name (Legal Business Name): ACCESS CARE PHYSICIANS OF NY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

256 MASON AVE BUILDING C
STATEN ISLAND NY
10305-3408
US

IV. Provider business mailing address

980 US HIGHWAY 9
SOUTH AMBOY NJ
08879-3320
US

V. Phone/Fax

Practice location:
  • Phone: 718-668-9729
  • Fax:
Mailing address:
  • Phone: 732-553-9729
  • Fax: 732-553-9730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND D FIGUEROA
Title or Position: CEO
Credential:
Phone: 717-235-0181