Staten Island Faculty Medical Affiliates, University Faculty Practice

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

STATEN ISLAND FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRACTICE

Practice address

475 Seaview Ave
Staten Island, NY 10305-3436

Phone

(718) 226-9000

Fax

(718) 226-8966

NPI assigned

Jul 8, 2024

Last updated

Jul 8, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sadaf Jalili, PA

Title

Physician Assistant

Phone

(718) 226-9000

Specialties & licenses 1

Addresses

Tax ID family

Staten Island Faculty Medical Affiliates University Faculty Practice2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Staten Island Faculty Medical Affiliates, University Faculty Practice

  • Gastroenterology Physician
  • Staten Island, NY
  • NPI 1346198942
  NPD tax ID

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1265278386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000",
            "fax_number": "718-226-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 SEAVIEW AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053436",
            "telephone_number": "718-226-9000",
            "fax_number": "718-226-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "JALILI",
        "authorized_official_first_name": "SADAF",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "718-226-9000",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.