Organization
ADVANCED UROLOGY CT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN BERNIE MD (OWNER)
(917) 502-8227
Entity
Organization
Contact information
Practice address
116 MASON ST, GREENWICH, CT 06830-2607
(917) 502-8227
Mailing address
55 GREENS FARMS RD STE 200-78, WESTPORT, CT 06880-6149
(917) 502-8227
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
07/01/2020
Last updated
07/01/2020
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