Organization
LONG ISLAND COLLEGE HOSPITAL UROLOGY ASSOCIATES AT LICH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE J CASDEN (CREDENTIALING MANAGER)
(718) 780-1520
Entity
Organization
Contact information
Practice address
339 HICKS ST, BROOKLYN, NY 11201-5509
(718) 780-1520
(718) 780-1362
Mailing address
339 HICKS ST, BROOKLYN, NY 11201-5509
(718) 780-1520
(718) 780-1362
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
154270-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02074959
—
NY
Enumeration date
05/26/2006
Last updated
06/24/2008
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