Staten Island Medical & Behavioral PC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

STATEN ISLAND MEDICAL & BEHAVIORAL PC

Practice address

31 New Dorp LN
Staten Island, NY 10306-2351

Phone

(917) 596-0451

NPI assigned

May 2, 2018

Organization subpart

No

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

Authorized official

Name

Tuzeen ShakirNPI 1275758294

Title

Owner

Phone

(917) 596-0451

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tuzeen Shakir

  • Psychiatry Physician
  • Staten Island, NY
  • NPI 1275758294

  NY, Psychiatry

  Medicare reassignment NPD Authorized official
• Frank M Cerasuolo

  • Psychiatry Physician
  • Staten Island, NY
  • NPI 1992907620

  Psychiatry

  NPD

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

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525219200000",
    "number": "1942799366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 WILLOWBROOK RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103141965",
            "telephone_number": "917-596-0451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 NEW DORP LN",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062351",
            "telephone_number": "917-596-0451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND MEDICAL & BEHAVIORAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-02",
        "last_updated": "2018-05-02",
        "status": "A",
        "authorized_official_last_name": "SHAKIR",
        "authorized_official_first_name": "TUZEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-596-0451"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.