Provider Demographics
NPI:1255418380
Name:ISLAND UROLOGICAL ASSOCIATES, P.C.
Entity type:Organization
Organization Name:ISLAND UROLOGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-766-2929
Mailing Address - Street 1:200 N VILLAGE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-2300
Mailing Address - Country:US
Mailing Address - Phone:516-766-2929
Mailing Address - Fax:516-766-7728
Practice Address - Street 1:200 N VILLAGE AVE STE 300
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2300
Practice Address - Country:US
Practice Address - Phone:516-766-2929
Practice Address - Fax:516-766-7728
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Not Answered2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0056000OtherGROUP HEALTH INCORPORATED