Provider Demographics
NPI:1467143172
Name:SOUTHERN WESTCHESTER UROLOGY PLLC
Entity Type:Organization
Organization Name:SOUTHERN WESTCHESTER UROLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:JANIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-664-7311
Mailing Address - Street 1:944 N BROADWAY STE G06
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-1313
Mailing Address - Country:US
Mailing Address - Phone:914-378-1000
Mailing Address - Fax:914-378-1951
Practice Address - Street 1:944 N BROADWAY STE G06
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1313
Practice Address - Country:US
Practice Address - Phone:914-378-1000
Practice Address - Fax:914-378-1951
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty