Organization
CENTER FOR SEXUAL AND URINARY FUNCTION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER NIEMCZYK M.D. (DIRECTOR)
(602) 531-5824
Entity
Organization
Contact information
Practice address
20325 N 51ST AVE, STE 102, GLENDALE, AZ 85308-5665
(623) 780-2300
(623) 582-9666
Mailing address
20325 N 51ST AVE, STE 102, GLENDALE, AZ 85308-5665
(623) 780-2300
(623) 582-9666
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
34718
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z136536
P-TAN
AZ
Enumeration date
01/08/2010
Last updated
05/21/2010
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