Organization
SOUTH NASSAU UROLOGY, PC
Active
Parent organization
SOUTH NASSAU COMMUNITIES HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTH NASSAU COMMUNITIES HOSPITAL
Authorized official
MARK BOGEN (CFO)
(516) 632-3965
Entity
Organization
Contact information
Practice address
155 W MERRICK RD, SUITE 204, FREEPORT, NY 11520-3743
(516) 876-0102
(516) 867-1857
Mailing address
1 HEALTHY WAY, PHYSICIAN BILLING, OCEANSIDE, NY 11572-1551
(516) 255-1616
(516) 255-4672
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
12/29/2015
Last updated
12/29/2015
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