Provider Demographics
NPI:1609087824
Name:THE UROLOGY GROUP OF CENTRAL NEW JERSEY
Entity Type:Organization
Organization Name:THE UROLOGY GROUP OF CENTRAL NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:C
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-390-4447
Mailing Address - Street 1:4 AUER CT
Mailing Address - Street 2:SUITES A&B
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5826
Mailing Address - Country:US
Mailing Address - Phone:732-390-4447
Mailing Address - Fax:732-390-0633
Practice Address - Street 1:4 AUER CT
Practice Address - Street 2:SUITES A&B
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5826
Practice Address - Country:US
Practice Address - Phone:732-390-4447
Practice Address - Fax:732-390-0633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-28
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA451622088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJCH2508OtherRAILROAD MEDICARE PTAN
NJ012449Medicare ID - Type UnspecifiedMEDICARE NUMBER