Organization
NORTH BRONX UROLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY BAEZ (COO)
(516) 693-0700
Entity
Organization
Contact information
Practice address
2016 BRONXDALE AVE, BRONX, NY 10462-3388
(718) 863-8695
(718) 863-5147
Mailing address
1100 SHAMES DR, WESTBURY, NY 11590-1765
(516) 693-0700
(516) 693-0271
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
196895
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01977513
—
NY
Enumeration date
01/26/2007
Last updated
08/22/2020
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