Organization
STATEN ISLAND SPECIAL SURGERY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER MALKIN (CEO)
(917) 815-2299
Entity
Organization
Contact information
Practice address
1112 SOUTH AVE, STATEN ISLAND, NY 10314-3410
(718) 982-0800
(718) 982-0811
Mailing address
1112 SOUTH AVE, STATEN ISLAND, NY 10314-3410
(718) 982-0800
(718) 982-0811
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
212519
NY
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
212519
NY
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
212519
NY
Other
Enumeration date
01/04/2010
Last updated
01/04/2010
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