SG MEDICAL PROFESSIONAL PC
NPI 1457085615
Family Medicine in Staten Island, NY

Q: What is Sg Medical Professional PC's NPI number?

The NPI number for Sg Medical Professional PC is 1457085615. It was assigned to this organization in the NPPES registry on July 13, 2022.

Q: What is Sg Medical Professional PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since July 13, 2022

260 CHRISTOPHER LN STE 102A, STATEN ISLAND, NY 10314(718) 362-1405(718) 414-1651 Get Directions Write a Review

NPPES record last updated: May 30, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 30, 2025, Apr 3, 2025, Jul 13, 2022 (3 updates tracked since 2022).

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About Sg Medical Professional Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SG MEDICAL PROFESSIONAL PC (NPI 1457085615) is a healthcare organization registered as a family medicine in Staten Island, New York and active in the NPI registry since July 2022. The organization lists Dov Hollander, Director Of Operations, as its authorized official.

NPPES Registry Identity

NPI1457085615

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameSG MEDICAL PROFESSIONAL PC

Location Address260 CHRISTOPHER LN STE 102AStaten Island, NY 10314-1631

Mailing Address45 S Route 9w Unit 41 #114West Haverstraw, NY 10993-1053 · (631) 759-9920 · Fax (315) 612-9793

Phone(718) 362-1405

Fax(718) 414-1651

Organization SubpartNo

Authorized OfficialDov HollanderDirector Of Operations · (631) 759-9920

Enumeration DateJuly 13, 2022

Last NPPES UpdateMay 30, 20253 updates tracked since enumeration

NPPES CertifiedMay 30, 2025

✔ NPI 1457085615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

260 CHRISTOPHER LN STE 102A, Staten Island, NY 10314

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MUSAFAU OLADIRAN ADENAIKE PMHNP

Nurse Practitioner (Psychiatric/Mental Health)