OrganizationActive
Staten Island University Hospital
NPI 1700480050 · Methadone Clinic · Staten Island, NY
Provider details
- NPI number
- 1700480050
- Entity type
- Organization
- Primary specialty
- Methadone ClinicAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Michele Cusack, Senior Vice President & Cfo(516) 321-6058
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
5 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
392 Seguine Ave
Staten Island, NY 10309-3906
Phone: (718) 226-3815
Fax: (718) 226-8144
Street-level locationGet directions
Mailing address
392 Seguine Ave
Staten Island, NY 10309-3906
Other names (DBA / former)
- Doing business as
- Opioid Treatment Program
Additional practice locations (4)
- 567 E 105th StBrooklyn, NY 11236-2213Phone: (718) 226-4930Fax: (718) 307-3020
- 475 Seaview AveStaten Island, NY 10305-3436Phone: (718) 226-5797
- 111 Water StStaten Island, NY 10304-2709Phone: (718) 226-4990Fax: (718) 447-6271
- 375 Seguine AveStaten Island, NY 10309-3932Phone: (718) 226-3815Fax: (718) 226-2920
Registry dates
- Enumerated
- 2020-11-27
- Last updated
- 2021-02-05
- Certified
- 2021-02-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.