Organization
GREATER NEW YORK LITHOTRIPSY, LLC
Active
Other names
NY Stone Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARWAN ATALLAH M.D. (PRESIDENT)
(718) 643-9371
Entity
Organization
Contact information
Practice address
339 HICKS ST, AT LONG ISLAND COLLEGE HOSPITAL 7TH FLR OTHMER, BROOKLYN, NY 11201-5509
(718) 780-1118
Mailing address
142 JORALEMON ST STE 14C, BROOKLYN, NY 11201-4709
(718) 643-9371
Taxonomy
Speciality
Code
Description
License number
State
261QL0400X
Lithotripsy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137987P
HIP PRISS
NE
01
—
2500316
AETNA HMO
NY
01
—
7881858
AETNA PPO
NE
Enumeration date
02/21/2007
Last updated
08/22/2020
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