Organization
INNOVATIVE UROLOGY PRACTICE OF NEW YORK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW I FISHMAN M.D. (OWNER)
(516) 455-1170
Entity
Organization
Contact information
Practice address
92-29 QUEENS BLVD., SUITE 2B, REGO PARK, NY 11374-1072
(718) 606-6912
(718) 606-6914
Mailing address
92-29 QUEENS BLVD., SUITE 2B, REGO PARK, NY 11374-1072
(718) 606-6912
(718) 606-6914
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
248604
NY
Other
Enumeration date
05/14/2014
Last updated
07/28/2014
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