Provider Demographics
NPI:1659328789
Name:SKYLANDS UROLOGY GROUP PA
Entity Type:Organization
Organization Name:SKYLANDS UROLOGY GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:T
Authorized Official - Last Name:SALVATORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-726-7220
Mailing Address - Street 1:89 SPARTA AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-1777
Mailing Address - Country:US
Mailing Address - Phone:973-726-7220
Mailing Address - Fax:973-726-7230
Practice Address - Street 1:89 SPARTA AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-1777
Practice Address - Country:US
Practice Address - Phone:973-726-7220
Practice Address - Fax:973-726-7230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ037667Medicare PIN