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General NPI Number Information
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NPI Number | 1730714221
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Entity Type | Organization
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Legal Business Name | TOTAL UROLOGY OFFICE BASED SURGERY LLC
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Dates
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Enumeration Date | 03/05/2020
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Last Update Date | 05/14/2020
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Provider Practice Location Address
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Address Line | 7 W 51ST ST STE 1&4 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-6910
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Country | US
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Telephone | 646-278-7288
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Fax |
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Provider Business Mailing Address
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Address Line | 7 W 51ST ST STE 1&4 8TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10019-6910
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Country | US
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Telephone | 646-278-7288
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Fax |
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Authorized Official
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Title or Position | GENERAL MANAGER
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Name | MR. GARY I ROSEN
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Credential |
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Telephone | 646-278-7288
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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 |
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