ISLAND INTERNIST PC NPI 1073669479

NPI Information

ISLAND INTERNIST PC is a general practice in Staten Island, NY. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee ISLAND INTERNIST PC NPI is 1073669479. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

420 LYNDALE AVE
STATEN ISLAND, NY
ZIP 10312-131
Phone: (718) 967-5630
Fax: (718) 967-7099

The provider's authorized official is Donna Seminara .
The authorized official title is Owner and has the following contact phone number (718) 967-1700.

The CLIA number assigned to this NPI record is 33D0968137 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/26/2007 and was last updated on 5/27/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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