Organization Active NPI

Stanley Boczko, MD PC

  • Urology Physician
  • New York, NY
National Provider Identifier
1942497607
Registry record updated Oct 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
120948-1 Issued in NY
Legal business name
STANLEY BOCZKO, MD PC
Practice address
23 E 79TH St
New York, NY 10075-0182
Phone
(212) 628-1800
Fax
(212) 628-1802
NPI assigned
Sep 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2010

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

Authorized official

Name
Mrs. Migdalia Santiago
Title
Office Manager
Phone
(212) 628-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 120948-1 NY Primary

Addresses

Primary practice location

23 E 79TH St
New York, NY 10075-0182

Mailing address

23 E 79TH St
New York, NY 10075-0182
Phone (212) 628-1800

Other identifiers 1

IdentifierTypeStateIssuer
00366303MedicaidNY

National Provider Directory

National Provider Directory

Locations

1180 Morris Park Ave
Ste 3
Bronx, NY 10461
Phone (347) 498-2410

3050 Corlear Ave
Ste 201
Bronx, NY 10463
Phone (718) 543-2700

1234 Central Park Ave
Ste 3A
Yonkers, NY 10704
Phone (914) 961-7212

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287964800000",
    "number": "1942497607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 E 79TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750182",
            "telephone_number": "212-628-1800",
            "fax_number": "212-628-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 E 79TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100750182",
            "telephone_number": "212-628-1800",
            "fax_number": "212-628-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANLEY BOCZKO, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2010-10-25",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "MIGDALIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "212-628-1800",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "NY",
            "license": "120948-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00366303",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2010; 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.