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General NPI Number Information
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NPI Number | 1396755922
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Entity Type | Organization
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Legal Business Name | STATEN ISLAND UNIVERSITY HOSPITAL
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 78 MEISNER AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-1234
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Country | US
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Telephone | 718-226-6456
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Fax | 718-226-6607
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Provider Business Mailing Address
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Address Line | 475 SEAVIEW AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10305-3436
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Country | US
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Telephone | 718-226-9034
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Fax | 718-226-8966
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT & CFO
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Name | MRS. MICHELE L CUSACK
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Credential |
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Telephone | 516-321-6058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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