Provider Demographics
NPI:1265767743
Name:ORANGE COUNTY UROLOGICAL SURGICARE PC
Entity type:Organization
Organization Name:ORANGE COUNTY UROLOGICAL SURGICARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWALB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-344-1952
Mailing Address - Street 1:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:TALLMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10982-0335
Mailing Address - Country:US
Mailing Address - Phone:845-344-1952
Mailing Address - Fax:
Practice Address - Street 1:12 GROVE ST
Practice Address - Street 2:SUITE B
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4806
Practice Address - Country:US
Practice Address - Phone:845-344-1952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY162828-1208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYC13562Medicare Oscar/Certification