Organization
STATEN ISLAND GSC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER BRUN MD (VICE PRESIDENT)
(718) 450-4870
Entity
Organization
Contact information
Practice address
2043 RICHMOND AVE FL 1, STATEN ISLAND, NY 10314-3964
(718) 975-7574
Mailing address
2043 RICHMOND AVE FL 1, STATEN ISLAND, NY 10314-3964
(718) 975-7574
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/02/2023
Last updated
02/02/2023
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