OPIOID TREATMENT PROGRAM
NPI 1700480050
Clinic/Center - Methadone in Staten Island, NY

Q: What is Staten Island University Hospital's NPI number?

The NPI number for Staten Island University Hospital is 1700480050. It was assigned to this organization in the NPPES registry on November 27, 2020. The provider is doing business as Opioid Treatment Program.

Q: What is Staten Island University Hospital's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Methadone, with taxonomy code 261QM2800X.

Active since November 27, 2020

392 SEGUINE AVE, STATEN ISLAND, NY 10309(718) 226-3815(718) 226-8144 Get Directions Write a Review

NPPES record last updated: February 5, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 5, 2021, Nov 27, 2020 (2 updates tracked since 2020).

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About Opioid Treatment Program NPPES

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

OPIOID TREATMENT PROGRAM (NPI 1700480050) is a healthcare organization registered as a methadone in Staten Island, New York and active in the NPI registry since November 2020. The organization maintains 4 additional practice locations and lists Michele L Cusack, Senior Vice President & Cfo, as its authorized official.

NPPES Registry Identity

NPI1700480050

Entity TypeOrganization

Primary Taxonomy261QM2800X

Legal Business NameSTATEN ISLAND UNIVERSITY HOSPITAL

Location Address392 SEGUINE AVEStaten Island, NY 10309-3906

Mailing Address392 Seguine AveStaten Island, NY 10309-3906 · (718) 226-3815 · Fax (718) 226-8144

Phone(718) 226-3815

Fax(718) 226-8144

Organization SubpartNo

Authorized OfficialMichele L CusackSenior Vice President & Cfo · (516) 321-6058

Enumeration DateNovember 27, 2020

Last NPPES UpdateFebruary 5, 20212 updates tracked since enumeration

NPPES CertifiedFebruary 5, 2021

✔ NPI 1700480050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities

Taxonomy Code261QM2800X

Definition

An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

392 SEGUINE AVE, Staten Island, NY 10309

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Other Names 1

Doing Business AsOpioid Treatment Program

Secondary Practice Locations 4

Location 1375 Seguine AveStaten Island, NY 10309-3932 · Phone (718) 226-3815 · Fax (718) 226-2920

Location 2111 Water StStaten Island, NY 10304-2709 · Phone (718) 226-4990 · Fax (718) 447-6271

Location 3567 E 105th StBrooklyn, NY 11236-2213 · Phone (718) 226-4930 · Fax (718) 307-3020

Location 4475 Seaview AveStaten Island, NY 10305-3436 · Phone (718) 226-5797

Other Providers at the Same Location NPPES 20

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

SHARON CARLO-AMATO LCSW

Social Worker (Clinical)