Organization
STATEN ISLAND UNIVERSITY HOSPITAL
Active
Other names
Opioid Treatment Program
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELE L CUSACK (SENIOR VICE PRESIDENT & CFO)
(516) 321-6058
Entity
Organization
Contact information
Practice address
392 SEGUINE AVE, STATEN ISLAND, NY 10309-3906
(718) 226-3815
(718) 226-8144
Mailing address
392 SEGUINE AVE, STATEN ISLAND, NY 10309-3906
(718) 226-3815
(718) 226-8144
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
11/27/2020
Last updated
02/05/2021
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