STONY BROOK UROLOGY UNIVERSITY FACULTY PRACTICE CORPORATION NPI 1538114707

NPI Information

NPI: 1538114707
Provider Name: STONY BROOK UROLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION
Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 33D0692170

Address:
24 RESEARCH WAY
SUITE 500
EAST SETAUKET, NY
ZIP 11733
Phone: (631) 444-6270
Get Directions

STONY BROOK UROLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION is an urology in East Setauket, NY. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. STONY BROOK UROLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION NPI is 1538114707. The provider is registered as an organization entity type.

The provider's business location address is:

24 RESEARCH WAY
SUITE 500
EAST SETAUKET, NY
ZIP 11733-487
Phone: (631) 444-6270

The provider's authorized official is Wayne Waltzer .
The authorized official title is Chair Person and has the following contact phone number (631) 444-1252.

The CLIA number assigned to this NPI record is 33D0692170 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/24/2006 and was last updated on 6/20/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center				No
2	208800000X	Urology				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00778890	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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