Organization
NEW YORK CITY UROLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY BLAIVAS M.D. (MEMBER)
(212) 772-3900
Entity
Organization
Contact information
Practice address
445 E 77TH ST, NEW YORK, NY 10075-2318
(212) 772-3900
(212) 772-1919
Mailing address
445 E 77TH ST, NEW YORK, NY 10075-2318
(212) 772-3900
(212) 772-1919
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
07/13/2010
Last updated
07/13/2010
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