Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Staten Island Medical Practice, PC

Organization Primary Care Clinic/Center · NPI 1104142082

Staten Island Medical Practice, PC is a Primary Care Clinic/Center in Staten Island, New York. Licensed in New York. Registered with an NPI since 2010.

Licensed in
NY
In the registry since
2010
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5405 Hylan Blvd
Staten Island, NY 10312-5241
Phone: (718) 948-5475
Fax: (718) 948-5479
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X · Licence 191751 (NY)

Record details

NPI number1104142082
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Leonard Marchetta — Physicians' Assistant · (718) 948-5475
NPI enumeratedApril 16, 2010
Last updated in NPPESApril 16, 2010
Mailing address5405 Hylan Blvd, Staten Island, NY 10312-5241

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