# UNITED STATES COAST GUARD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043346216
- **Authorized official:** DR. QUIRICO CABREDO DOCTOR (COMMANDER)
- **Authorized official phone:** (718) 354-4414

## Contact information

- **Practice address:** 215 DRUM RD, STATEN ISLAND, NY 10305-5001
- **Practice address phone:** (718) 354-4414
- **Mailing address:** 215 DRUM RD, STATEN ISLAND, NY 10305-5001
- **Mailing address phone:** (718) 354-4414

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302R00000X | Health Maintenance Organization | 17100000X | NY | Yes |

## Other

- **Enumeration date:** 02/24/2007
- **Last updated:** 06/18/2008