Organization
KINGSTON UROLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS V STELLATO M.D. (SOLE PROPRIETOR)
(845) 339-6022
Entity
Organization
Contact information
Practice address
40 HURLEY AVE, SUITE 17, KINGSTON, NY 12401-3739
(845) 339-6022
(845) 339-5467
Mailing address
40 HURLEY AVE, SUITE 17, KINGSTON, NY 12401-3739
(845) 339-6022
(845) 339-5467
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
116375-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01379157
—
NY
01
—
W12501
PTAN
—
Enumeration date
11/17/2006
Last updated
02/12/2016
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