Provider Demographics
NPI:1053340901
Name:METROPOLITAN LITHOTRIPTOR ASSOCIATES
Entity type:Organization
Organization Name:METROPOLITAN LITHOTRIPTOR ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT COO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:MANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-742-8800
Mailing Address - Street 1:450 PARK AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:646-742-8815
Mailing Address - Fax:212-481-8162
Practice Address - Street 1:2578 HEMPSTEAD TURNPIKE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554
Practice Address - Country:US
Practice Address - Phone:516-731-8118
Practice Address - Fax:516-731-9263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1000332OtherGHI
IC7854OtherHEALTHNET
8459536OtherAETNA
NYAZ00256Medicaid
001151OtherHORIZON
ANC144OtherOXFORD
293999OtherUNITED HEALTH CARE
97003OtherCIGNA
97003OtherCIGNA