Advanced Adult & Pediatric Urology LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA76499 Issued in NJ

Legal business name

ADVANCED ADULT & PEDIATRIC UROLOGY LLC

Practice address

300 Mercer St
Apt 22D
New York, NY 10003-6724

Phone

(617) 797-5090

Fax

(212) 228-3438

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Shahbandi, MD

Title

Owner

Phone

(617) 797-5090

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740235597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MERCER ST",
            "address_2": "APT 22D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036724",
            "telephone_number": "617-797-5090",
            "fax_number": "212-228-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MERCER ST",
            "address_2": "APT 22D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100036724",
            "telephone_number": "617-797-5090",
            "fax_number": "212-228-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED ADULT & PEDIATRIC UROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAHBANDI",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-797-5090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA76499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in New York, NY
• Providers in New York, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.