Provider Demographics
NPI:1720370786
Name:METROPOLITAN UROLOGICAL SPECIALIST, PC
Entity Type:Organization
Organization Name:METROPOLITAN UROLOGICAL SPECIALIST, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLER
Authorized Official - Prefix:MS
Authorized Official - First Name:NINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-742-8815
Mailing Address - Street 1:450 PARK AVE S
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7320
Mailing Address - Country:US
Mailing Address - Phone:646-742-8815
Mailing Address - Fax:646-742-8850
Practice Address - Street 1:2510 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-3512
Practice Address - Country:US
Practice Address - Phone:212-481-8118
Practice Address - Fax:212-213-3455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWS3142Medicare PIN