Provider Demographics
NPI:1174660393
Name:GATEWAY UROLOGY, P.A.
Entity Type:Organization
Organization Name:GATEWAY UROLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-742-5011
Mailing Address - Street 1:17 OLD ROLLINSFORD RD
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-2833
Mailing Address - Country:US
Mailing Address - Phone:603-742-5011
Mailing Address - Fax:603-742-3530
Practice Address - Street 1:875 GREENLAND RD
Practice Address - Street 2:ORCHARD PARK, BLDG C, SUITE 3
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4164
Practice Address - Country:US
Practice Address - Phone:603-436-8601
Practice Address - Fax:603-436-8603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty