Staten Island Medical Practice, P.C.

LBN: Staten Island Medical Practice, P.C.
Staten Island Medical Practice, P.C. is an health care organization with primary practice located at 5405 Hylan Blvd , Staten Island NY 10312-5241. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Staten Island Medical Practice, P.C. can be contacted via phone (718) 948-5475, or through Marchetta, Leonard J via phone (718) 948-5475.

Contact Information

Primary practice address
5405 Hylan Blvd Staten Island NY 10312-5241
Phone: (718) 948-5475
Fax: (718) 948-5479
Website:
Map and Directions
Authorized official contact:
Name: Marchetta, Leonard J RPA
Phone: (718) 948-5475

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 191751 New York

Profile Details

NPI number 1104142082
LBN Legal business name Staten Island Medical Practice, P.C.
DBA Doing business as
Authorized official Marchetta, Leonard J RPA
Entity Organization
Organization subpart 1 No
Enumeration date Apr 16th, 2010
Last updated Apr 16th, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104142082 NPPES
Other 11177655 CAQH
MEDICAID 01860833 CAQH

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