Staten Island Special Surgery P.C.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

212519 Issued in NY

Legal business name

STATEN ISLAND SPECIAL SURGERY P.C.

Practice address

1112 South Ave
Staten Island, NY 10314-3410

Phone

(718) 982-0800

Fax

(718) 982-0811

NPI assigned

Jan 4, 2010

Organization subpart

No

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

Authorized official

Name

Spencer Malkin

Title

Ceo

Phone

(917) 815-2299

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1689904211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 SOUTH AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143410",
            "telephone_number": "718-982-0800",
            "fax_number": "718-982-0811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 SOUTH AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143410",
            "telephone_number": "718-982-0800",
            "fax_number": "718-982-0811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND SPECIAL SURGERY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "MALKIN",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-815-2299"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "212519",
            "primary": true
        },
        {
            "code": "2082S0099X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": "NY",
            "license": "212519",
            "primary": false
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "NY",
            "license": "212519",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Staten Island Rehabilitation Medicine PC
• Staten Island Reproductive Medicine PLLC
• Staten Island Smile Dental PLLC
• Staten Island Smiles at the Pavillion
• Staten Island Social Adult Day Care Inc
• Staten Island Sports Chiropractic, P.C.
• Staten Island Surgical Associates, PC
• Staten Island University Hospital
• Staten Island University Hospital
• Staten Island University Hospital

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.