Provider Demographics
NPI:1760446173
Name:UROLOGY SPECIALISTS, P. C.
Entity Type:Organization
Organization Name:UROLOGY SPECIALISTS, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER M. D.
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:203-757-8361
Mailing Address - Street 1:1579 STRAITS TPKE
Mailing Address - Street 2:SUITE 2 A
Mailing Address - City:MIDDLEBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06762-1835
Mailing Address - Country:US
Mailing Address - Phone:203-757-8361
Mailing Address - Fax:203-754-9126
Practice Address - Street 1:1579 STRAITS TPKE
Practice Address - Street 2:SUITE 2A
Practice Address - City:MIDDLEBURY
Practice Address - State:CT
Practice Address - Zip Code:06762-1835
Practice Address - Country:US
Practice Address - Phone:203-757-8361
Practice Address - Fax:203-754-9126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC000112Medicare ID - Type Unspecified