Provider Demographics
NPI:1164623344
Name:SUMMIT UROLOGY P A
Entity Type:Organization
Organization Name:SUMMIT UROLOGY P A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:I
Authorized Official - Last Name:MARGOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-859-9494
Mailing Address - Street 1:224 ROSEBERRY ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1687
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:224 ROSEBERRY ST
Practice Address - Street 2:SUITE 2
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1687
Practice Address - Country:US
Practice Address - Phone:908-859-9494
Practice Address - Fax:908-213-9203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2007-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA72178208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1487727517OtherINDIVIDUAL NPI NUMBER
PA056660Medicare ID - Type UnspecifiedMEDICARE PROVIDER NO - PA
1487727517OtherINDIVIDUAL NPI NUMBER
NJ047330Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID NJ