1427119346 NPI number — SPECIALISTS IN UROLOGY, P.A.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427119346 NPI number — SPECIALISTS IN UROLOGY, P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SPECIALISTS IN UROLOGY, P.A.
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:
1427119346
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
534 AVENUE E
Provider Second Line Business Mailing Address:
SUITE 2A
Provider Business Mailing Address City Name:
BAYONNE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07002-3987
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-823-1303
Provider Business Mailing Address Fax Number:
201-823-0944

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
534 AVENUE E
Provider Second Line Business Practice Location Address:
SUITE 2A
Provider Business Practice Location Address City Name:
BAYONNE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07002-3987
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-823-1303
Provider Business Practice Location Address Fax Number:
201-823-0944
Provider Enumeration Date:
12/13/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KATZ
Authorized Official First Name:
HERBERT
Authorized Official Middle Name:
I.
Authorized Official Title or Position:
M.D.
Authorized Official Telephone Number:
201-823-1303

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  25MA03586600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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