| Tottenville Medical Pavilion, Pllc | |
|
7098 Amboy Road Staten Island NY 10307 | |
| (718) 356-5600 | |
| Not Available |
| Full Name | Tottenville Medical Pavilion, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7098 Amboy Road, Staten Island, New York |
| Authorized Official Name and Position | Bari F Ceka (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7183565600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tottenville Medical Pavilion, Pllc 7098 Amboy Road Staten Island NY 10307 Ph: (718) 356-5600 | Tottenville Medical Pavilion, Pllc 7098 Amboy Road Staten Island NY 10307 Ph: (718) 356-5600 |
| NPI Number | 1164594925 |
|---|---|
| Provider Enumeration Date | 11/15/2006 |
| Last Update Date | 03/31/2014 |
| Medicare PECOS PAC ID | 8729206537 |
|---|---|
| Medicare Enrollment ID | O20140820000082 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164594925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 234924 (New York) | Primary |
| Provider Name | Bari F Ceka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003992074 PECOS PAC ID: 8325074008 Enrollment ID: I20050713001194 |
| Provider Name | Richard M Hayes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104814896 PECOS PAC ID: 8325068422 Enrollment ID: I20051205000455 |
| Provider Name | Peter D'orazio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518980606 PECOS PAC ID: 0547361917 Enrollment ID: I20171025000843 |
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