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NPI Code Detail

MEDICARE: LAKE SUCCESS UROLGICAL ASSOCIATES

MEDICARE: LAKE SUCCESS UROLGICAL ASSOCIATES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianNY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1C131591OTHERGARAILROAD MEDICARE B

General Provider Information

NPI Number : 1104823673
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAKE SUCCESS UROLGICAL ASSOCIATES
Provider Business Mailing Address
First Line : 2001 MARCUS AVE
Second Line : SUITE N-214
City : LAKE SUCCESS
State : NY
Zip : 11042-1011
Country : US
Telephone Number : 516-437-4228
Fax Number : 516-355-0637
Provider Business Practice Location Address
First Line : 2001 MARCUS AVE
Second Line : SUITE N-214
City : LAKE SUCCESS
State : NY
Zip : 11042-1011
Country : US
Telephone Number : 516-437-4228
Fax Number : 516-355-0637
Authorized Official
Title or Position : BILLING MANAGER
Name : RUTH BORRERO
Credential :
Telephone Number : 516-437-4228
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/21/2022

Similar Medicare Providers

1174520621 — MICHAEL M ZIEGELBAUM MD
Practice Location Address:
2001 MARCUS AVE , SUITE N-214
LAKE SUCCESS, NY
11042-1011
Practice Phone: 516-437-4228
Practice Fax: 516-355-0637
1689671141 — SANFORD A MEYERSFIELD MD
Practice Location Address:
2001 MARCUS AVE , SUITE N-214
LAKE SUCCESS, NY
11042-1011
Practice Phone: 516-437-4228
Practice Fax: 516-355-0637
1942207493 — MITCHELL I BUCHBINDER MD
Practice Location Address:
2001 MARCUS AVE , SUITE N-214
LAKE SUCCESS, NY
11042-1011
Practice Phone: 516-437-4228
Practice Fax: 516-355-0637
1750388146 — MICHAEL A LEVINE MD
Practice Location Address:
2001 MARCUS AVE , SUITE N-214
LAKE SUCCESS, NY
11042-1011
Practice Phone: 516-437-4228
Practice Fax: 516-355-0637
1649279084 — DR. MARK F SOMMER DDS
Practice Location Address:
2001 MARCUS AVE , SUITE W82
LAKE SUCCESS, NY
11042-1011
Practice Phone: 516-328-1144
Practice Fax: 516-328-1147
1851383194 — PERRY J MILMAN MD
Practice Location Address:
2001 MARCUS AVE , STE N18
LAKE SUCCESS, NY
11042-1011
Practice Phone: 516-775-7770
Practice Fax: 516-775-8080

Directions to “LAKE SUCCESS UROLGICAL ASSOCIATES ” Practice Location

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