Organization
ADVANCED UROLOGY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL OSTAD MD (DOCTOR)
(718) 505-1177
Entity
Organization
Contact information
Practice address
3739 75TH ST, JACKSON HEIGHTS, NY 11372-6422
(718) 505-1177
(718) 505-2046
Mailing address
PO BOX 720066, JACKSON HEIGHTS, NY 11372-0066
(718) 505-1177
(718) 505-2046
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
197422
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A100097628
MEDICARE
NY
Enumeration date
10/11/2006
Last updated
09/08/2014
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