NPI 1053820704

Si Senior Center INC

Organisation Health Maintenance Organization Staten Island, NY

Practice location

Address: 364 Bay St, Staten Island, NY 10301-3267
Phone: (917) 780-0002
Mailing address: 691 Tompkins Ave, Staten Island, NY 10305-3033

Authorised official

Name: Suk Han Tai
Title: President
Phone: (347) 886-9791

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X

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Registry record

NPI: 1053820704
Entity type: Organization
NPI issued: 26 Sep 2017
Record last updated: 26 Sep 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.