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NPI Code Detail

MEDICARE: UROLOGICAL ROBOTIC SURGERY PC

MEDICARE: UROLOGICAL ROBOTIC SURGERY PC
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
12088F0040XUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician

General Provider Information

NPI Number : 1578387445
Entity Type Code : Organization
Provider Name (Legal Business Name) : UROLOGICAL ROBOTIC SURGERY PC
Provider Business Mailing Address
First Line : 135 PINELAWN RD STE 115
Second Line :
City : MELVILLE
State : NY
Zip : 11747-3198
Country : US
Telephone Number : 516-584-8710
Fax Number : 516-584-8711
Provider Business Practice Location Address
First Line : 308 WILLOW AVE RM 111
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-3808
Country : US
Telephone Number : 516-584-8710
Fax Number : 516-584-8711
Authorized Official
Title or Position : PRESIDENT OWNER
Name : ANDREA VIDALI
Credential : MD
Telephone Number : 631-456-2514
Provider Enumeration Date : 11/08/2024
Last Update Date : 06/04/2026

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