Provider Demographics
NPI:1063467421
Name:ASSOCIATES IN UROLOGY ,LLC
Entity Type:Organization
Organization Name:ASSOCIATES IN UROLOGY ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEFKON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-325-6100
Mailing Address - Street 1:741 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1174
Mailing Address - Country:US
Mailing Address - Phone:973-325-1616
Mailing Address - Fax:
Practice Address - Street 1:741 NORTHFIELD AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1174
Practice Address - Country:US
Practice Address - Phone:973-325-1616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA02960500208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ405849Medicare ID - Type Unspecified