Southern Tier Urology Clinic

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

234985 Issued in NY

Legal business name

SOUTHERN TIER UROLOGY CLINIC

Practice address

3359 Laurie Brook Dr
Binghamton, NY 13903-3153

Phone

(202) 636-1131

NPI assigned

Apr 21, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Christopher W Gist, MD

Title

Director

Phone

(202) 636-1131

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1303344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303344000000",
    "number": "1346531654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 LAURIE BROOK DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139033153",
            "telephone_number": "202-636-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3359 LAURIE BROOK DR",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139033153",
            "telephone_number": "202-636-1131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN TIER UROLOGY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-21",
        "last_updated": "2011-04-21",
        "status": "A",
        "authorized_official_last_name": "GIST",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "202-636-1131",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": "NY",
            "license": "234985",
            "primary": true
        },
        {
            "code": "2088P0231X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology, Pediatric Urology",
            "state": "NY",
            "license": "234985",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clark Trevor Soulia, LMSW
• Southern Tier Associates in Podiatric Medicine & Surgery PLLC
• Southern Tier Independence Center, Inc.
• Southern Tier Medical Care - Ny PC
• Southern Tier Physical Therapy of Binghamton PC
• Janet Spadavecchia, DMD
• Margo Ann Spak, LMT
• Jacqueline M. Spalik, MSPT
• Nicole Sparaco, RN
• Shawn Patrick Sparks, GRNA

• Urology Physician in Binghamton, NY
• Providers in Binghamton, NY by specialty
• Urology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2011; 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.