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General NPI Number Information
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NPI Number | 1518109800
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Entity Type | Organization
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Legal Business Name | SI BAYVIEW MEDICAL GROUP, PC
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 500 SEAVIEW AVENUE
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City | STATEN ISLAND
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State | NJ
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Zip | 10305
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Country | US
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Telephone | 718-667-1777
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 464
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City | RUTHERFORD
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State | NJ
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Zip | 07070-0464
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Country | US
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Telephone | 201-804-2800
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Fax | 201-804-8883
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. ROBERT GASALBERTI
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Credential | MD
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Telephone | 718-667-1777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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