| Island Medical Specialists, P.l.l.c. | |
|
2627 Hylan Blvd Ste C Staten Island NY 10306-4344 | |
| (718) 351-1136 | |
| (718) 667-9711 |
| Full Name | Island Medical Specialists, P.l.l.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2627 Hylan Blvd Ste C, Staten Island, New York |
| Authorized Official Name and Position | Lori Guterman (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 7188766220 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Island Medical Specialists, P.l.l.c. 2627 Hylan Blvd Ste C Staten Island NY 10306-4344 Ph: (718) 351-1136 | Island Medical Specialists, P.l.l.c. 2627 Hylan Blvd Ste C Staten Island NY 10306-4344 Ph: (718) 351-1136 |
| NPI Number | 1407844160 |
|---|---|
| Provider Enumeration Date | 10/07/2005 |
| Last Update Date | 12/21/2022 |
| Medicare PECOS PAC ID | 9436137817 |
|---|---|
| Medicare Enrollment ID | O20040712000977 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407844160 | NPI | - | NPPES |
| 02679945 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (New York) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (New York) | Secondary |
| Provider Name | Joseph F Hederman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457349185 PECOS PAC ID: 1456242429 Enrollment ID: I20040322000488 |
| Provider Name | Patricia Murray Given |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639167364 PECOS PAC ID: 4789664699 Enrollment ID: I20040721001677 |
| Provider Name | Leonard Lefkovic |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548258270 PECOS PAC ID: 7214824358 Enrollment ID: I20040721001709 |
| Provider Name | Lucinda Ripoll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609864339 PECOS PAC ID: 6103806021 Enrollment ID: I20040721001717 |
| Provider Name | Noreen Tan-chu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578551214 PECOS PAC ID: 9537149455 Enrollment ID: I20040721001744 |
| Provider Name | Stavros Thomas Snyder |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780672410 PECOS PAC ID: 2769379809 Enrollment ID: I20040721001747 |
| Provider Name | Janet R. Monaco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295066876 PECOS PAC ID: 6507025160 Enrollment ID: I20120319000065 |
| Provider Name | Margery Shane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003172784 PECOS PAC ID: 1355504051 Enrollment ID: I20120516000348 |
| Provider Name | Sun Y Maeng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447804067 PECOS PAC ID: 3375975022 Enrollment ID: I20191118002100 |
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