Provider Demographics
NPI:1013119296
Name:METROPOLITAN UROLOGICAL ASSOC PC
Entity Type:Organization
Organization Name:METROPOLITAN UROLOGICAL ASSOC PC
Other - Org Name:METROPOLITAN UROLOGICAL ASSOCIATES, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:C
Authorized Official - Last Name:RUBENSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-665-9385
Mailing Address - Street 1:441 MAIN STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176
Mailing Address - Country:US
Mailing Address - Phone:781-665-9385
Mailing Address - Fax:781-665-1031
Practice Address - Street 1:441 MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3859
Practice Address - Country:US
Practice Address - Phone:781-665-9385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA43277208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty