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General NPI Number Information
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NPI Number | 1205148269
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Entity Type | Organization
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Legal Business Name | ST VINCENT'S UROLOGY
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Dates
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Enumeration Date | 07/07/2010
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Last Update Date | 07/07/2010
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Provider Practice Location Address
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Address Line | 100 E 77TH ST 4TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10075-1850
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Country | US
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Telephone | 212-434-6300
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Fax | 212-434-6370
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Provider Business Mailing Address
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Address Line | 100 EAST 77TH STREET 4TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10075
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Country | US
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Telephone | 212-434-6300
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Fax | 212-434-6370
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL GRASSO III
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Credential | M.D.
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Telephone | 212-434-6300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 197903
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License Number State | NY
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