South Nassau Urology, PC

NPI #1578928933 in Freeport, New York

Provider Information

NPI Number: 1578928933
Entity Type: Organization
Organization Name: South Nassau Urology, PC
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTH NASSAU COMMUNITIES HOSPITAL
Primary Specialty: Urology
Enumeration Date: Dec 29, 2015
Last Updated: Dec 29, 2015

Practice Location

Address: 155 W MERRICK RD
Address 2: SUITE 204
City: Freeport
State: New York
ZIP Code: 11520-3743
Phone: (516) 876-0102

Authorized Official

Name: MARK BOGEN
Title: CFO
Phone: (516) 632-3965

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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