DR. GARY DOUGLAS BOZEMAN (NPI# 1659348514) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659348514 |
| Entity Type | Individual |
| Full Name | DR. GARY DOUGLAS BOZEMAN |
| Credential | M.D. |
| Practice Address |
806 W Broadway Fulton NY 13069-1533 |
| Mailing Address |
1226 E Water St Syracuse NY 13210-1155 |
| Practice Telephone | 3152974700 |
| Practice Fax Number | 3152185898 |
| Mailing Telephone | 3154784185 |
| Mailing Fax Number | 3154780840 |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2014-02-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 272579 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 153372 | 05 |
| Street Address |
806 W BROADWAY |
| City | FULTON |
| State | NY |
| Zip Code | 13069-1533 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952879173 | Rebecca Anne Zenor | Technician/Technologist | 806 W Broadway, Fulton, NY 13069-1571 | 2018-11-06 |
| 1386062990 | Associated Medical Professionals of Ny, Pllc | Urology | 806 W Broadway, Fulton, NY 13069-1533 | 2014-04-01 |
| 1891751764 | Elizabeth Bozeman | Urology | 806 W Broadway, Fulton, NY 13069-1533 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588291454 | Awilda Vega Johnston | Counselor | 92 N. 2nd St., #100, Fulton, NY 13069 | 2020-03-23 |
| 1174169346 | Gabrielle Sunshine Chrestler | Technician | 2118 Co Rt 176, Fulton, NY 13069 | 2019-11-22 |
| 1558917310 | Renee Omsby | Technician | 1323 County Rte 9, Fullton, NY 13069 | 2019-08-16 |
| 1194208488 | Bridgette Lynn Godfrey | Registered Nurse | 167 South 4th Street, Fulton, NY 13069 | 2018-09-12 |
| 1205299195 | Nu-ops, Inc | Taxi | 107 West 4th St So, Fulton, NY 13069 | 2016-03-30 |
| 1770909061 | Siobhan Anne Walsh | Licensed Practical Nurse | 436 Rowlee Road, Fulton, NY 13069 | 2014-03-11 |
| 1982971743 | Jennifer Lynn Scaringi | Licensed Practical Nurse | 505 Seneca St, Fulton, NY 13069 | 2011-11-22 |
| 1215242680 | Meghan Kathleen Hill | Physical Therapist | 706 South 4th St, Fulton, NY 13069 | 2010-08-10 |
| 1659699064 | Daniel Petrescu | Physical Therapist | 453 Park St., Michaud Residential Healthcare, Fulton, NY 13069 | 2010-05-10 |
| 1528212842 | Robyn Elizabeth Mccann | Licensed Practical Nurse | 464 Red School House Road, Fulton, NY 13069 | 2008-11-13 |
| Find all providers in zip 13069 | ||||
| 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 |
|---|---|---|---|---|
| 1023188596 | Oswego County Urology PC | Urology | 826 Holly Dr, Fulton, NY 13069 | 2006-11-09 |
| 1386062990 | Associated Medical Professionals of Ny, Pllc | Urology | 806 W Broadway, Fulton, NY 13069-1533 | 2014-04-01 |
| 1437318557 | David M. Fenig | Urology | 7625 Maple Lawn Blvd, Suite 210, Fulton, MD 20759-2565 | 2008-06-04 |
| 1700951456 | Lisa Nipkow Hawes | Urology | 7625 Maple Lawn Blvd, # 210, Fulton, MD 20759-2565 | 2006-11-21 |
| 1528011129 | Victoria Ruth Staiman | Urology | 7625 Maple Lawn Blvd, Ste 210, Fulton, MD 20759-2565 | 2006-05-18 |
| 1891751764 | Elizabeth Bozeman | Urology | 806 W Broadway, Fulton, NY 13069-1533 | 2006-04-21 |
| 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 | ||||
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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.