Staten Island Faculty Medical Affiliates, University Faculty Practice

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

Based on the most recent information from CMS, provider Staten Island Faculty Medical Affiliates, University Faculty Practice does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 5 days ago.

Profile Details

Provider ID
1265278386
Provider Type
Organization
Full Name
Staten Island Faculty Medical Affiliates, University Faculty Practice

Subpart
No
Enumeration Date
7/8/2024
Last Updated
7/8/2024

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9000

(718) 226-8966

Mailing Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9000

(718) 226-8966

Authorized Official

Jalili, Sadaf (Physician Assistant)

(718) 226-9000

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Staten Island Faculty Medical Affiliates, University Faculty Practice

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

Shkandriy, Tetyana

Lantowski, Agnieszka

Lipnitskiy, Mona Trinette

Yevtukhov, Allen

Lanter, Amanda

Rasile, Jacqueline Marie

Chopra, Raji

Roytman, Petr

Tantawi, Nada Sherif

Giuseffi, Nicholas