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General NPI Number Information
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NPI Number | 1639140254
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Entity Type | Organization
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Legal Business Name | SEAGATE RADIATION ONCOLOGY PC
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Dates
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Enumeration Date | 01/31/2006
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 1781 HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10305-1917
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Country | US
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Telephone | 718-351-9750
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Fax | 718-351-9756
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Provider Business Mailing Address
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Address Line | 1781 HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10305-1917
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Country | US
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Telephone | 718-351-9750
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Fax | 718-351-9756
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA N HALPERN
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Credential | MD
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Telephone | 917-328-0679
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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