Staten Island Pulmonary Assoc PC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

107251 Issued in NY

Legal business name

STATEN ISLAND PULMONARY ASSOC PC

Practice address

501 Seaview Ave
Suite 102
Staten Island, NY 10305-3400

Phone

(718) 980-5700

Fax

(781) 980-5499

NPI assigned

May 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Theodore J Maniatis, M.D.

Title

President

Phone

(718) 980-5700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373328000000",
    "number": "1780895425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 SEAVIEW AVE",
            "address_2": "SUITE 102",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053400",
            "telephone_number": "718-980-5700",
            "fax_number": "781-980-5499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SEAVIEW AVE",
            "address_2": "SUITE 102",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103053400",
            "telephone_number": "718-980-5700",
            "fax_number": "781-980-5499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND PULMONARY ASSOC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2013-07-09",
        "status": "A",
        "authorized_official_last_name": "MANIATIS",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-980-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NY",
            "license": "107251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "W07191",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.