MEDICARE: WASHINGTON HEIGHTS UROLOGY

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
1	208800000X	Urology Physician		NY

General Provider Information

NPI Number	:	1548367949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WASHINGTON HEIGHTS UROLOGY

Provider Business Mailing Address
First Line	:	PO BOX 83
Second Line	:	AUDUBON STATION
City	:	NEW YORK
State	:	NY
Zip	:	10032-0083
Country	:	US
Telephone Number	:	212-781-9696
Fax Number	:	631-878-4280

Provider Business Practice Location Address
First Line	:	286 FORT WASHINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10032-1315
Country	:	US
Telephone Number	:	212-781-9696
Fax Number	:	631-878-4280

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSE CONTRERAS
Credential	:	M.D.
Telephone Number	:	212-781-9696

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/21/2022

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