| Staten Island Medical & Behavioral Pc | |
|
31 New Dorp Ln Staten Island NY 10306-2351 | |
| (917) 596-0451 | |
| Not Available |
| Full Name | Staten Island Medical & Behavioral Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 31 New Dorp Ln, Staten Island, New York |
| Authorized Official Name and Position | Tuzeen Shakir (OWNER) |
| Authorized Official Contact | 9175960451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Staten Island Medical & Behavioral Pc 425 Willowbrook Rd Staten Island NY 10314-1965 Ph: (917) 596-0451 | Staten Island Medical & Behavioral Pc 31 New Dorp Ln Staten Island NY 10306-2351 Ph: (917) 596-0451 |
| NPI Number | 1942799366 |
|---|---|
| Provider Enumeration Date | 05/02/2018 |
| Last Update Date | 05/02/2018 |
| Medicare PECOS PAC ID | 6608121959 |
|---|---|
| Medicare Enrollment ID | O20180611000871 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942799366 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Tuzeen Shakir |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275758294 PECOS PAC ID: 4981858131 Enrollment ID: I20130218000038 |
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