AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC – NPI #1619172970
Clinic/Center

AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC is an AHC clinic located in STATEN ISLAND, NY. NPPES has assigned the NPI number 1619172970 to AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC on June 18, 2007. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was last updated on Sep 11, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC below.

NPI Profile for
AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC

NPI Number
1619172970
Enumeration Date

(about 19 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AESTHETIC PAVILION AMBULATORY SURGERY CENTER LLC
Primary location
2777 HYLAN BLVD
STATEN ISLAND, NY 10306-4660
Phone: (718) 987-9165 Fax: (718) 987-0305
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JOHN DECORATO
PRESIDENT
Phone: (718) 987-9165
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)
261QR1100X
- Clinic/Center / Research

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.