STATEN ISLAND LITHOTRIPSY LLC


Address: 1324 Forest Ave, #228, Staten Island, NY 10302-2028
Phone: 5203238732

STATEN ISLAND LITHOTRIPSY LLC (NPI# 1457539561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457539561
Entity Type Organization
Organization Name STATEN ISLAND LITHOTRIPSY LLC
Practice Address 1324 Forest Ave
#228
Staten Island
NY 10302-2028
Mailing Address 6339 E Speedway Blvd
Suite 201
Tucson
AZ 85710-1147
Practice Telephone 5203238732
Practice Fax Number 5205471865
Mailing Telephone 5203238732
Mailing Fax Number 5205471865
Enumeration Date 2008-01-31
Last Update Date 2008-10-01
Authorized Official Name MARY ANN EVANOSKI (BILLING MANAGER)
Authorized Official Telephone 5205474130
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
Ambulatory Health Care Facilities

Office Location

Street Address 1324 FOREST AVE
#228
City STATEN ISLAND
State NY
Zip Code 10302-2028

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NPI Name Taxonomy Address Enumeration
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NPI Name Taxonomy Address Enumeration
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1912453788 Adewunmi Bankole Registered Nurse 124 Nicholas Avenue Apt B, Staten Island, NY 10302 2016-08-31
1154788974 Eileen Patricia Cameron Counselor 263-267 Port Richmond Aveune, Staten Island, NY 10302 2016-01-25
1225468432 Total Dental Care of Staten Island, P.C. Dentist 135 Willowbrook Road, Staten Island, NY 10302 2013-11-25
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1962751255 Kathleen Gomez-rodriguez Speech-Language Pathologist 12 Crystal Ave, Staten Island, NY 10302 2012-09-03
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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1588834303 Richmond Ambulatory Surgical Facility Pllc Clinic/Center 7 Burbank Ave., Staten Island, NY 10306 2008-03-07
1730540600 Richmond Asc LLC Clinic/Center 1360 Hylan Blvd, Staten Island, NY 10305-1922 2016-03-18
1902262322 As Medical PC Clinic/Center 2493 Richmond Rd, Suite 2, Staten Island, NY 10306 2016-01-14
1578801296 Richmond Surgical Gps PC Clinic/Center 2066 Richmond Ave, Staten Island, NY 10314-3916 2013-01-31
1134477508 Richmond Surgical Center Corp. Clinic/Center 2066 Richmond Ave, Staten Island, NY 10314-3916 2012-08-16
1326302803 Staten Island Medical Group, Pllc Clinic/Center 2071 Clove Rd, Staten Island, NY 10304-1612 2012-06-28
1598036402 Trinity Cardiovascular Services, Pllc Clinic/Center 5091 Amboy Rd, Staten Island, NY 10312-4722 2012-01-24
1235431842 Victory Ambulatroy Services, LLC Clinic/Center 1534 Victory Blvd, Staten Island, NY 10314-3529 2010-12-02
1114153889 Coddington Office Based Surgery, PC Clinic/Center 5 Coddington Ave, Suite 103, Staten Island, NY 10306-4305 2009-06-08
1992957682 Victoryendoscopyunit,pllc Clinic/Center 2281 Victory Blvd, Staten Island, NY 10314-6625 2008-10-14
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Competitor

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City STATEN ISLAND
Zip Code 10302

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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