New York Surgical Associates Office Based Surgery, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

209637-1 Issued in NY

Legal business name

NEW YORK SURGICAL ASSOCIATES OFFICE BASED SURGERY, PC

Practice address

2235 Clove Rd
Suite #2
Staten Island, NY 10305-1566

Phone

(718) 815-2300

Fax

(718) 815-8200

NPI assigned

Aug 13, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Tomasine Fodera, MD

Title

Owner

Phone

(718) 815-2300

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1313193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313193600000",
    "number": "1255610887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 CLOVE RD",
            "address_2": "SUITE #2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051566",
            "telephone_number": "718-815-2300",
            "fax_number": "718-815-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 CLOVE RD",
            "address_2": "SUITE #2",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103051566",
            "telephone_number": "718-815-2300",
            "fax_number": "718-815-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK SURGICAL ASSOCIATES OFFICE BASED SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-13",
        "last_updated": "2011-08-13",
        "status": "A",
        "authorized_official_last_name": "FODERA",
        "authorized_official_first_name": "TOMASINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-815-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "209637-1",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "204537-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.