# SEAVIEW SKIN CANCER SURGERY, LLC

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

## Provider details

- **NPI number:** 1407133440
- **Authorized official:** DR. TINA PELORO MD (MOHS SURGEON)
- **Authorized official phone:** (732) 995-2967

## Contact information

- **Practice address:** 256 MASON AVE \# C, THIRD FLOOR, STATEN ISLAND, NY 10305-3408
- **Practice address phone:** (718) 226-1251
- **Practice address fax:** (718) 226-1252
- **Mailing address:** 256 MASON AVE \# C, THIRD FLOOR, STATEN ISLAND, NY 10305-3408
- **Mailing address phone:** (718) 226-1251
- **Mailing address fax:** (718) 226-1252

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 201613-1 | NY | Yes |

## Other

- **Enumeration date:** 11/04/2011
- **Last updated:** 11/04/2011