Provider Demographics
NPI:1265446801
Name:UROLOGY GROUP PC
Entity Type:Organization
Organization Name:UROLOGY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-288-6465
Mailing Address - Street 1:9 WASHINGTON AVE
Mailing Address - Street 2:SUITE 3A
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3267
Mailing Address - Country:US
Mailing Address - Phone:203-288-6465
Mailing Address - Fax:203-288-6256
Practice Address - Street 1:9 WASHINGTON AVE
Practice Address - Street 2:SUITE 3A
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3267
Practice Address - Country:US
Practice Address - Phone:203-288-6465
Practice Address - Fax:203-288-6256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty