Organization
AMSTERDAM UROLOGY ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD REZA GHAZI-MOGHADAM MD (PHYSICIAN)
(518) 843-1449
Entity
Organization
Contact information
Practice address
425 GUY PARK AVENUE, SUITE 203, AMSTERDAM, NY 12010
(518) 843-1449
(518) 843-8215
Mailing address
425 GUY PARK AVENUE, SUITE 203, AMSTERDAM, NY 12010
(518) 843-1449
(518) 843-8215
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
1326381
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00557268
—
NY
01
—
10000753
CDPHP
—
01
—
24109
MVP
—
Enumeration date
10/03/2006
Last updated
08/22/2020
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