SOUTHERN TIER UROLOGY CLINIC (NPI# 1346531654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346531654 |
| Entity Type | Organization |
| Organization Name | SOUTHERN TIER UROLOGY CLINIC |
| Practice Address |
3359 Laurie Brook Dr Binghamton NY 13903-3153 |
| Practice Telephone | 2026361131 |
| Mailing Telephone | 2026361131 |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2011-04-21 |
| Authorized Official Name | DR. CHRISTOPHER W GIST (DIRECTOR) |
| Authorized Official Telephone | 2026361131 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2088P0231X |
Urology Specialization: Pediatric Urology |
234985 | NY | Allopathic & Osteopathic Physicians |
| Y | 208800000X | Urology | 234985 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
3359 LAURIE BROOK DR |
| City | BINGHAMTON |
| State | NY |
| Zip Code | 13903-3153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982241121 | Diane Irene Davie | Specialist | 37 1/2 Hayes St, Binghamton, NY 13903 | 2019-12-06 |
| 1801440375 | Jonathan James Pelc | Pharmacist | 50 Pennsylvania Avenue, Binghamton, NY 13903 | 2019-08-01 |
| 1265815211 | Miriam Mikaya | Nurse Practitioner | 10-42 Mitchel Avenue, Binghamton, NY 13903 | 2015-07-08 |
| 1538541925 | Marianne Valenzuela | Nurse Practitioner | 27 Park Avenue, 5th Floor, Binghamton, NY 13903 | 2015-06-23 |
| 1962884379 | Norman Dale Powell Sr. | Nurse's Aide | 43 Webster St., Apt. 2, Binghamton, NY 13903 | 2015-06-22 |
| 1659612562 | Helena Maureen Ladue | Counselor | 10 Mitchell Avenue, New Horizons, Binghamton, NY 13903 | 2013-03-04 |
| 1144597527 | Allan M. Fernandez | Family Medicine | 35 Felters Road, Building 8, Binghamton, NY 13903 | 2011-11-29 |
| 1386875482 | Earle John Reome | Pharmacist | 10-34 Mitchell Avenue, Binghamton, NY 13903 | 2009-08-06 |
| 1619113149 | Teresa Mae Grant | Massage Therapist | 20 Mitchell Avenue, Binghamton, NY 13903 | 2009-01-06 |
| 1932383791 | Diane Lucille Brenner | Licensed Practical Nurse | 60 Saratoga Ave, 5 20, Binghamton, NY 13903 | 2007-12-28 |
| Find all providers in zip 13903 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245297001 | Rayford A Petroski | Urology | 169 Riverside Drive, Depaul Pavilion, Binghamton, NY 13905-4246 | 2006-04-27 |
| 1417221318 | Alexandria Clarinda Lynch | Urology | 169 Riverside Dr, Broome Urology At Lourdes, Binghamton, NY 13905-4246 | 2012-02-24 |
| 1538256136 | Peter E Lethin | Urology | 169 Riverside Dr, Depaul Pavilion, Binghamton, NY 13905-4246 | 2006-10-06 |
| 1225125784 | John W Miller | Urology | 169 Riverside Dr, Depaul Pavilion, Binghamton, NY 13905-4246 | 2006-10-06 |
| 1003903568 | James R Steinmetz | Urology | 169 Riverside Dr, Depaul Pavilion, Binghamton, NY 13905-4246 | 2006-10-06 |
| 1588751069 | Broome Urological Associates, L.l.p. | Urology | 169 Riverside Dr, Depaul Pavilion, Binghamton, NY 13905-4246 | 2006-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639787955 | Alexandra Gavalo-yacco | Urology | 100 S Bedford Rd, Mount Kisco, NY 10549-3425 | 2020-07-22 |
| 1710503230 | Alan Hugh Bennett | Urology | 592 State Route 28, Raquette Lake, NY 13436-1907 | 2020-06-20 |
| 1518587294 | Nitin Sharma | Urology | 755 N Broadway Ste 510, Sleepy Hollow, NY 10591-1084 | 2020-04-22 |
| 1730714221 | Total Urology Office Based Surgery LLC | Urology | 7 W 51st St Ste 1&4, 8th Floor, New York, NY 10019-6910 | 2020-03-05 |
| 1588298053 | Lake Country Urology Pllc | Urology | 400 5th Avenue, Brooklyn, NY 11215-3337 | 2020-02-24 |
| 1639709561 | American Medical PC | Urology | 45 W 34th St Rm 901, New York, NY 10001-3145 | 2020-01-20 |
| 1659917243 | Hanan Goldberg | Urology | 1676 Sunset Ave Fl 2, Utica, NY 13502-5416 | 2019-11-19 |
| 1063065787 | Edward Ezrick, M.d., P.C. | Urology | 7210 13th Ave Fl 3, Brooklyn, NY 11228-2009 | 2019-07-22 |
| 1902464720 | Manzoor Ul Mahbub | Urology | 8268 164th St Rm P129, Jamaica, NY 11432-1121 | 2019-06-05 |
| 1548728058 | Jose Miguel Flores Martinez | Urology | 16 E 60th St Ste 402, New York, NY 10022-1096 | 2019-03-05 |
| Find all providers with the same taxonomy | ||||
| City | BINGHAMTON |
| Zip Code | 13903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.