Staten Island Lithotripsy LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

STATEN ISLAND LITHOTRIPSY LLC

Practice address

1324 Forest Ave
#228
Staten Island, NY 10302-2028

Phone

(520) 323-8732

Fax

(520) 547-1865

NPI assigned

Jan 31, 2008

Organization subpart

No

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

Authorized official

Name

Mary Ann Evanoski

Title

Billing Manager

Phone

(520) 547-4130

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1201737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222819200000",
    "number": "1457539561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6339 E SPEEDWAY BLVD",
            "address_2": "SUITE 201",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101147",
            "telephone_number": "520-323-8732",
            "fax_number": "520-547-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 FOREST AVE",
            "address_2": "#228",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022028",
            "telephone_number": "520-323-8732",
            "fax_number": "520-547-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND LITHOTRIPSY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-31",
        "last_updated": "2008-10-01",
        "status": "A",
        "authorized_official_last_name": "EVANOSKI",
        "authorized_official_first_name": "MARY ANN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "520-547-4130"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.