Provider Demographics
NPI:1225282239
Name:UROLOGIC SURGICAL CONSULTANTS, PC
Entity Type:Organization
Organization Name:UROLOGIC SURGICAL CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:W
Authorized Official - Last Name:PLAWKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-233-1300
Mailing Address - Street 1:2454 HYLAN BLVD
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3117
Mailing Address - Country:US
Mailing Address - Phone:718-233-1300
Mailing Address - Fax:718-980-9728
Practice Address - Street 1:2454 HYLAN BLVD
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3117
Practice Address - Country:US
Practice Address - Phone:718-233-1300
Practice Address - Fax:718-980-9728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192813174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG46981Medicare UPIN