Provider Demographics
NPI:1457714230
Name:STATEN ISLAND PEDIATRIC HEMATOLOGY ONCOLOGY ASSOC.
Entity Type:Organization
Organization Name:STATEN ISLAND PEDIATRIC HEMATOLOGY ONCOLOGY ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:FRANCES
Authorized Official - Last Name:GRAZIANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-987-5717
Mailing Address - Street 1:314 SEAVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305-2246
Mailing Address - Country:US
Mailing Address - Phone:718-987-5717
Mailing Address - Fax:718-668-3420
Practice Address - Street 1:314 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-2246
Practice Address - Country:US
Practice Address - Phone:718-987-5717
Practice Address - Fax:718-668-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-30
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1893692080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Multi-Specialty