Healthcare Provider Details

I. General information

NPI: 1285676536
Provider Name (Legal Business Name): GRAMERCY UROLOGY SOLUTIONS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 01/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 IRVING PL 10TH FLOOR NORTH
NEW YORK NY
10003-2202
US

IV. Provider business mailing address

67 IRVING PL 10TH FLOOR NORTH
NEW YORK NY
10003-2202
US

V. Phone/Fax

Practice location:
  • Phone: 212-254-3570
  • Fax: 212-254-5351
Mailing address:
  • Phone: 212-254-3570
  • Fax: 212-254-5351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: MS. KATY R CHIANG
Title or Position: CEO
Credential:
Phone: 212-254-3570