Healthcare Provider Details

I. General information

NPI: 1912936857
Provider Name (Legal Business Name): METROPOLITAN LITHOTRIPTOR ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 WESTCHESTER AVE
WHITE PLAINS NY
10604
US

IV. Provider business mailing address

9825 SPECTRUM DR BLDG 3
AUSTIN TX
78717-4930
US

V. Phone/Fax

Practice location:
  • Phone: 914-428-6700
  • Fax: 914-428-8655
Mailing address:
  • Phone: 774-654-8458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QL0400X
TaxonomyLithotripsy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: PATRICIA SABLESAK
Title or Position: VP OF OPERATIONS & CLINICAL QUALITY
Credential:
Phone: 646-742-8801