Amsterdam Urology Associates PC

Organization Active NPI Urology Physician · Amsterdam, NY

NPI 1083708283 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1083708283
Entity type
Organization (NPI type 2)
Primary specialty
Urology Physician 208800000X
License
1326381 (NY)
Legal business name
AMSTERDAM UROLOGY ASSOCIATES PC
Practice address
425 Guy Park Avenue
Suite 203
Amsterdam, NY 12010
Phone
(518) 843-1449
Fax
(518) 843-8215
NPI assigned
Oct 3, 2006
Organization subpart
No

Authorized official

Name
Mohammad Reza Ghazi-Moghadam, MD
Title
Physician
Phone
(518) 843-1449

National Provider Directory

Locations

425 Guy Park Ave
Ste 203
Amsterdam, NY 12010
Phone (518) 843-1449

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
208800000X 1326381 NY Yes

Addresses

Primary practice location

425 Guy Park Avenue
Suite 203
Amsterdam, NY 12010

Mailing address

425 Guy Park Avenue
Suite 203
Amsterdam, NY 12010
Phone (518) 843-1449

Other identifiers

IdentifierTypeStateIssuer
24109OtherMVP
00557268MedicaidNY
10000753OtherCDPHP

Other providers in Amsterdam, NY

All providers in Amsterdam, NY · Urology Physician in New York

Sources for this page

Verify at the official NPI Registry.