Organization
PHYSICIANS OF UNIVERSITY HOSPITAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK JARRETT MD (DIRECTOR)
(516) 465-3214
Entity
Organization
Contact information
Practice address
375 SEGUINE AVE, 2ND FL., STATEN ISLAND, NY 10309-3932
(718) 226-6789
(718) 226-6224
Mailing address
1 EDGEWATER ST, 6TH FL. PAYER RELATIONS DEPT., STATEN ISLAND, NY 10305-4900
(718) 226-1008
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
2080P0205X
Pediatric Endocrinology Physician
—
—
208200000X
Plastic Surgery Physician
—
—
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2084P0805X
Geriatric Psychiatry Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02808139
—
NY
Enumeration date
05/22/2006
Last updated
12/03/2025
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