Healthcare Provider Details

I. General information

NPI: 1164472387
Provider Name (Legal Business Name): NEW YORK UROLOGICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 E 54TH ST 2N
NEW YORK NY
10022-4707
US

IV. Provider business mailing address

245 E 54TH ST 2N
NEW YORK NY
10022-4707
US

V. Phone/Fax

Practice location:
  • Phone: 212-570-6800
  • Fax: 212-734-7425
Mailing address:
  • Phone: 212-570-6800
  • Fax: 212-734-7425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: JANET BERNSTEIN
Title or Position: PRACTICE MANAGER
Credential:
Phone: 212-570-6800