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General NPI Number Information
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NPI Number | 1447281233
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Entity Type | Organization
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Legal Business Name | ST. VINCENT'S STATEN ISLAND SURGERY SERVICES
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Dates
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Enumeration Date | 07/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 355 BARD AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1664
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Country | US
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Telephone | 718-818-1085
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Fax | 718-818-4293
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Provider Business Mailing Address
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Address Line | 450 W 33RD ST 12TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10001-2603
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Country | US
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Telephone | 212-356-4400
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Fax |
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Authorized Official
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Title or Position | SR. VICE PRESIDENT
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Name | MICHAEL CALDER
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Credential |
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Telephone | 212-356-5944
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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