STATEN ISLAND MEDICAL OF NEW YORK LLC NPI 1669864369

NPI Information

STATEN ISLAND MEDICAL OF NEW YORK, LLC is a vascular surgery surgery in Staten Island, NY. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. STATEN ISLAND MEDICAL OF NEW YORK, LLC NPI is 1669864369. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1975 HYLAN BLVD STE C
STATEN ISLAND, NY
ZIP 10306
Phone: (847) 305-3346
Fax: (888) 979-6720

The provider's authorized official is Yan Katsnelson .
The authorized official title is Director and has the following contact phone number (847) 257-1244.

The enumeration date for this NPI number is 3/4/2015 and was last updated on 5/24/2018.

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:

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