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General NPI Number Information
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NPI Number | 1073669479
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Entity Type | Organization
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Legal Business Name | ISLAND INTERNIST PC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 05/27/2010
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Provider Practice Location Address
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Address Line | 420 LYNDALE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6131
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Country | US
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Telephone | 718-967-5630
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Fax | 718-967-7099
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Provider Business Mailing Address
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Address Line | 420 LYNDALE AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6131
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Country | US
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Telephone | 718-967-1700
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Fax | 718-967-7099
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONNA SEMINARA
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Credential | M.D.
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Telephone | 718-967-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 179723
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 22415
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 171607
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 234484
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 234387
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License Number State | NY
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