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General NPI Number Information
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NPI Number | 1578718979
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Entity Type | Organization
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Legal Business Name | OB-GYN ASSOCIATES OF STATEN ISLAND, P.C.
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Dates
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Enumeration Date | 11/26/2008
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 1984 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2550
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Country | US
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Telephone | 718-668-2096
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Fax | 718-667-1388
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Provider Business Mailing Address
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Address Line | 1984 RICHMOND RD
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City | STATEN ISLAND
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State | NY
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Zip | 10306-2550
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Country | US
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Telephone | 718-668-2096
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Fax | 718-667-1388
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Authorized Official
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Title or Position | MANAGER
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Name | MS. DOROTHY J. SELLITTO
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Credential |
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Telephone | 718-668-2096
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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