Healthcare Provider Details

I. General information

NPI: 1124056692
Provider Name (Legal Business Name): NEW YORK UROLOGICAL ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 5TH AVE
NEW YORK NY
10021-4951
US

IV. Provider business mailing address

880 5TH AVE
NEW YORK NY
10021-4951
US

V. Phone/Fax

Practice location:
  • Phone: 212-570-6800
  • Fax: 212-861-7964
Mailing address:
  • Phone: 212-570-6800
  • Fax: 212-861-7964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNY

VIII. Authorized Official

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