Organization
STATEN ISLAND UNIVERSITY HOSPITAL
Active
Parent organization
NORTH SHORE LIJ
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTH SHORE LIJ
Authorized official
OTAR DATAN MD (PGY-1)
(917) 655-6207
Entity
Organization
Contact information
Practice address
227 KOCH BLVD, STATEN ISLAND, NY 10312-5416
(917) 655-6207
Mailing address
227 KOCH BLVD, STATEN ISLAND, NY 10312-5416
(917) 655-6207
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
NY
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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