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PLAZA UROLOGY ASSOCIATES
BROOKLYN, NEW YORK


Appointment Requests

To schedule an appointment, please call or submit your request online after reviewing the disclaimer below.

Online Appointment Requests

You may send appointment requests using the form below. Please do not use it to send any other messages. Medical questions will not be answered via email.

Please Note: Sending messages over regular Internet lines, such as with the form below, is not a secure form of communication and therefore the privacy of your message cannot be guaranteed while transmitting across the Internet.

Full name:
Email address:
Phone number*:
*[Phone number is a required field.]
Time and date preferred, 1st choice:
Time and date preferred, 2nd choice:
Referring doctor's name:
Insurance information:
Other scheduling notes:
(Medical questions will not be answered via email.)


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PLAZA UROLOGY ASSOCIATES

60 Plaza Street #1L
Brooklyn, New York 11238
Tel: 718.638.9222
Fax: 718.638.9357
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