| Staten Island University Hospital | |
|
475 Seaview Ave Staten Island NY 10305-3436 | |
| (718) 226-4502 | |
| (718) 226-4875 |
| Full Name | Staten Island University Hospital |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 475 Seaview Ave, Staten Island, New York |
| Authorized Official Name and Position | Michele Cusack (SVP AND CFO) |
| Authorized Official Contact | 5163216058 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Staten Island University Hospital 475 Seaview Ave Staten Island NY 10305-3436 Ph: (718) 226-4502 | Staten Island University Hospital 475 Seaview Ave Staten Island NY 10305-3436 Ph: (718) 226-4502 |
| NPI Number | 1912925199 |
|---|---|
| Provider Enumeration Date | 07/17/2006 |
| Last Update Date | 08/14/2019 |
| Medicare PECOS PAC ID | 8628985504 |
|---|---|
| Medicare Enrollment ID | O20071017000762 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912925199 | NPI | - | NPPES |
| 330860 | Other | NJ | BLUE CROSS PSYCH |
| 000881 | Other | NY | BLUE CROSS PSYCH |
| 00244202 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 7004003H (New York) | Primary |
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