Provider Demographics
NPI:1881610400
Name:ROCKLAND UROLOGY ASSOCIATES
Entity type:Organization
Organization Name:ROCKLAND UROLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LATINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-354-5000
Mailing Address - Street 1:6 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970-3525
Mailing Address - Country:US
Mailing Address - Phone:845-354-5000
Mailing Address - Fax:845-354-9469
Practice Address - Street 1:6 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3525
Practice Address - Country:US
Practice Address - Phone:845-354-5000
Practice Address - Fax:845-354-9469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2008-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY178898208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY74H981Medicare ID - Type Unspecified
NY6598538761Medicare PIN
NY55T491Medicare ID - Type Unspecified
NY23K251Medicare ID - Type Unspecified
NY24A351Medicare ID - Type Unspecified
NY3S2531Medicare ID - Type Unspecified
NY632781Medicare ID - Type Unspecified
NY1257020001Medicare NSC
NYW38761Medicare ID - Type Unspecified