Provider Demographics
NPI:1730714221
Name:TOTAL UROLOGY OFFICE BASED SURGERY LLC
Entity type:Organization
Organization Name:TOTAL UROLOGY OFFICE BASED SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:I
Authorized Official - Last Name:ROSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-278-7288
Mailing Address - Street 1:7 W 51ST ST STE 1&4
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-6910
Mailing Address - Country:US
Mailing Address - Phone:646-278-7288
Mailing Address - Fax:
Practice Address - Street 1:7 W 51ST ST STE 1&4
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-6910
Practice Address - Country:US
Practice Address - Phone:646-278-7288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty