Organization Active NPI

East 12TH Street Urology PLLC

  • Urology Physician
  • Brooklyn, NY
National Provider Identifier
1225880248
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
EAST 12TH STREET UROLOGY PLLC
Practice address
1729 E 12TH St FL 5
Brooklyn, NY 11229-1088
Phone
(718) 369-3300
NPI assigned
Apr 3, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jonathan N Lazare
Title
MD
Phone
(718) 369-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

1729 E 12TH St FL 5
Brooklyn, NY 11229-1088

Mailing address

1729 E 12TH St FL 5
Brooklyn, NY 11229-1088
Phone (718) 369-3300

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1225880248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1729 E 12TH ST FL 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291088",
            "telephone_number": "718-369-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 E 12TH ST FL 5",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291088",
            "telephone_number": "718-369-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST 12TH STREET UROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "LAZARE",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "718-369-3300"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.