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General NPI Number Information
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NPI Number | 1811051592
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Entity Type | Organization
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Legal Business Name | NY UROGYNECOLOGY & RECONSTRUCTIVE PELVIC SURGERY PC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 7206 NARROWS AVE
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City | BROOKLYN
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State | NY
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Zip | 11209-1811
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Country | US
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Telephone | 718-836-9579
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Fax |
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Provider Business Mailing Address
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Address Line | 25 HASTINGS CT
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City | STATEN ISLAND
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State | NY
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Zip | 10309-3552
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Country | US
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Telephone | 718-966-8346
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAROUTYOUN MARGOSSIAN
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Credential | MD
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Telephone | 718-836-9579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 217158-1
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License Number State | NY
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