Staten Island Reproductive Medicine PLLC

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

Legal business name

STATEN ISLAND REPRODUCTIVE MEDICINE PLLC

Practice address

1441 South Ave # 201
Staten Island, NY 10314-3425

Phone

(973) 548-0900

NPI assigned

Feb 11, 2022

Organization subpart

No

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

Authorized official

Name

Lisa Miller

Title

Finance Manager

Phone

(732) 317-8286

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644537600000",
    "number": "1821742487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 OLD SHORT HILLS RD STE 403",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070395672",
            "telephone_number": "973-548-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 SOUTH AVE # 201",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143425",
            "telephone_number": "973-548-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND REPRODUCTIVE MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2022-02-11",
        "certification_date": "2022-02-11",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "732-317-8286"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Edison",
            "affiliation": "N",
            "address_1": "1441 South Ave # 201",
            "city": "Staten Island",
            "state": "NY",
            "country_code": "US",
            "postal_code": "103143425",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.