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General NPI Number Information
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NPI Number | 1861270076
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Entity Type | Organization
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Legal Business Name | EMPIRE CENTER FOR SPECIAL SURGERY, LLC
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Dates
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Enumeration Date | 09/19/2023
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 4855 HYLAN BLVD
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6319
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Country | US
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Telephone | 718-804-5422
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Fax |
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Provider Business Mailing Address
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Address Line | 65 BROADWAY FL 14
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City | NEW YORK
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State | NY
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Zip | 10006-2516
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Country | US
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Telephone | 718-682-8180
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Fax | 718-682-8181
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Authorized Official
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Title or Position | BOARD CHAIR
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Name | DR. JASON D KOFINAS
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Credential |
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Telephone | 718-682-8180
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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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