OrganizationActive
Lake Success Urolgical Associates
NPI 1104823673 · Urology Physician · Lake Success, NY
Provider details
- NPI number
- 1104823673
- Entity type
- Organization
- Primary specialty
- Urology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Ruth Borrero, Billing Manager(516) 437-4228
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2001 Marcus Ave
Suite N-214
Lake Success, NY 11042-1011
Phone: (516) 437-4228
Fax: (516) 355-0637
Street-level locationGet directions
Mailing address
2001 Marcus Ave
Lake Success, NY 11042-1011
Registry dates
- Enumerated
- 2005-06-30
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.