Provider Demographics
NPI:1093744864
Name:METROPOLITAN UROLOGICAL SPECIALIST PC
Entity Type:Organization
Organization Name:METROPOLITAN UROLOGICAL SPECIALIST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:LINTEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-742-8833
Mailing Address - Street 1:450 PARK AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:646-742-8815
Mailing Address - Fax:212-481-8162
Practice Address - Street 1:222 WESTCHESTER AVENUE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604
Practice Address - Country:US
Practice Address - Phone:914-428-6700
Practice Address - Fax:914-428-8655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWS3142Medicare PIN