Provider Demographics
NPI:1235326687
Name:UROSONICS INC
Entity Type:Organization
Organization Name:UROSONICS INC
Other - Org Name:UROSONICS INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:
Authorized Official - Last Name:RESNIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-233-4417
Mailing Address - Street 1:PO BOX 5487
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05402-5487
Mailing Address - Country:US
Mailing Address - Phone:802-233-4417
Mailing Address - Fax:802-879-7000
Practice Address - Street 1:792 COLLEGE PKWY STE 302
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3052
Practice Address - Country:US
Practice Address - Phone:802-879-0019
Practice Address - Fax:802-879-7000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTVT9467Medicare PIN