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Organization
STATEN ISLAND MEDICAL GROUP, PLLC
Active
Organization
STATEN ISLAND MEDICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSEMARIE PHILLIP MD (MEDICAL DIRECTOR)
(201) 857-4011
Entity
Organization
Contact information
Practice address
2071 CLOVE RD, STATEN ISLAND, NY 10304-1612
(718) 391-0303
Mailing address
PO BOX 581, SADDLE RIVER, NJ 07458-0581
(201) 857-4011
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
4431
NY
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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