Provider Demographics
NPI:1043350473
Name:SUMMIT UROLOGIC ASSOCIATES
Entity Type:Organization
Organization Name:SUMMIT UROLOGIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:GIANIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:908-273-8854
Mailing Address - Street 1:475 SPRINGFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2600
Mailing Address - Country:US
Mailing Address - Phone:908-273-8854
Mailing Address - Fax:908-273-4585
Practice Address - Street 1:475 SPRINGFIELD AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2600
Practice Address - Country:US
Practice Address - Phone:908-273-8854
Practice Address - Fax:908-273-4585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA052941174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty