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General NPI Number Information
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NPI Number | 1043124563
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Entity Type | Organization
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Legal Business Name | EXCELSIOR UROLOGY PLLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 11203 QUEENS BLVD STE 204
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City | FOREST HILLS
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State | NY
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Zip | 11375-5550
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Country | US
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Telephone | 718-902-0877
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Fax | 716-779-3262
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Provider Business Mailing Address
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Address Line | 11203 QUEENS BLVD STE 204
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City | FOREST HILLS
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State | NY
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Zip | 11375-5550
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Country | US
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Telephone | 718-902-0877
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Fax | 716-779-3262
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RUBEN PINKHASOV
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Credential |
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Telephone | 646-407-9791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State | NULL
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