Staten Islan University Hospital

Primary specialty

Methadone ClinicTaxonomy code 261QM2800X

Legal business name

STATEN ISLAN UNIVERSITY HOSPITAL

Practice address

567 E 105TH St
Brooklyn, NY 11236-2213

Phone

(718) 307-3000

Fax

(718) 307-3020

NPI assigned

Dec 14, 2011

Organization subpart

No

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

Authorized official

Name

Wilfredo Gonzalez, CACAC

Title

Manager

Phone

(718) 307-3000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323820800000",
    "number": "1841569282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 E 105TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362213",
            "telephone_number": "718-307-3000",
            "fax_number": "718-307-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 E 105TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112362213",
            "telephone_number": "718-307-3000",
            "fax_number": "718-307-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAN UNIVERSITY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-14",
        "last_updated": "2011-12-14",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "WILFREDO",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-307-3000",
        "authorized_official_credential": "CACAC"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• State of New York Comptrollers Office
• State Social Adult Daycare Inc
• State University of New York at Downstate Medical Center
• State University of New York, Health Science Center at Brooklyn
• Sara C State, M.S.
• Staten Island Eye Physicians PLLC
• Staten Island University Hospital
• Antonio Staten
• Skyler States
• Statewide Medical and Surgical Supplies Inc.

• Methadone Clinic in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Methadone Clinic in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2011; 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.