STATEN ISLAND MEDICAL OF NEW YORK, LLC
NPI 1669864369
Surgery - Vascular Surgery in Staten Island, NY

Q: What is Staten Island Medical Of New York, LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

Active since March 04, 2015

1975 HYLAN BLVD STE C, STATEN ISLAND, NY 10306(847) 305-3346(888) 979-6720 Get Directions Write a Review

NPPES record last updated: May 24, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 24, 2018, May 7, 2018 (2 updates tracked since 2018).

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About Staten Island Medical Of New York, Llc NPPES

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

STATEN ISLAND MEDICAL OF NEW YORK, LLC (NPI 1669864369) is a healthcare organization registered as a vascular surgery in Staten Island, New York and active in the NPI registry since March 2015. The organization lists Yan Katsnelson, Director, as its authorized official.

NPPES Registry Identity

NPI1669864369

Entity TypeOrganization

Primary Taxonomy2086S0129X

Legal Business NameSTATEN ISLAND MEDICAL OF NEW YORK, LLC

Location Address1975 HYLAN BLVD STE CStaten Island, NY 10306

Mailing Address4141 Dundee RdNorthbrook, IL 60062-2129 · (847) 257-1244 · Fax (224) 246-8042

Phone(847) 305-3346

Fax(888) 979-6720

Organization SubpartNo

Authorized OfficialYan KatsnelsonDirector · (847) 257-1244

Enumeration DateMarch 4, 2015

Last NPPES UpdateMay 24, 20182 updates tracked since enumeration

✔ NPI 1669864369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgery · Vascular SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code2086S0129X

Definition

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

1975 HYLAN BLVD STE C, Staten Island, NY 10306

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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

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Staten Island Medical Of New York, LLC's NPI number?

The NPI number for Staten Island Medical Of New York, LLC is 1669864369. It was assigned to this organization in the NPPES registry on March 4, 2015.

Where is Staten Island Medical Of New York, LLC located?

Staten Island Medical Of New York, LLC is located at 1975 Hylan Blvd Ste C, Staten Island, NY 10306. The listed phone number is (847) 305-3346.

What is Staten Island Medical Of New York, LLC's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.

When was this NPI record last updated?

The NPPES record for Staten Island Medical Of New York, LLC was last updated on May 24, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.