Provider Demographics
NPI:1073707709
Name:UROLOGY ASSOCIATES OF THE POCONOS,INC
Entity Type:Organization
Organization Name:UROLOGY ASSOCIATES OF THE POCONOS,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MOYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:570-424-2100
Mailing Address - Street 1:422 NORMAL ST
Mailing Address - Street 2:
Mailing Address - City:EAST STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18301-2717
Mailing Address - Country:US
Mailing Address - Phone:570-424-2100
Mailing Address - Fax:570-421-7407
Practice Address - Street 1:422 NORMAL ST
Practice Address - Street 2:SUITE B
Practice Address - City:EAST STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18301-8260
Practice Address - Country:US
Practice Address - Phone:570-424-2100
Practice Address - Fax:570-421-7407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0717220001Medicare NSC