1154579647 NPI number — UROLOGY GROUP OF NEW JERSEY LLC

Table of content: DR. ALEXA TAYLOR MILUS DC (NPI 1902414097)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154579647 NPI number — UROLOGY GROUP OF NEW JERSEY LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UROLOGY GROUP OF NEW JERSEY LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154579647
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/23/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
741 NORTHFIELD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST ORANGE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07052-1174
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-325-6100
Provider Business Mailing Address Fax Number:
973-325-1616

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
375 MT. PLEASANT AVE, SUITE 250
Provider Second Line Business Practice Location Address:
UROLOGY GROUP OF NJ, LLC
Provider Business Practice Location Address City Name:
WEST ORANGE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-323-1320
Provider Business Practice Location Address Fax Number:
973-323-1329
Provider Enumeration Date:
09/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
KRIEGER
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
973-323-1321

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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