Organization
LICH FACULTY PRACTICE
Active
Other names
UROLOGY AT LICH
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUZANNE CASDEN (CREDENTIALING MANAGER)
(516) 569-0696
Entity
Organization
Contact information
Practice address
339 HICKS ST, 7TH FLOOR, BROOKLYN, NY 11201-5509
(718) 780-1520
(718) 780-1362
Mailing address
339 HICKS ST, 7TH FLOOR, 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
Enumeration date
11/09/2009
Last updated
11/15/2009
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