Provider Demographics
NPI:1659418408
Name:UROLOGIC HEALTH CENTER OF N.J. P.C.
Entity Type:Organization
Organization Name:UROLOGIC HEALTH CENTER OF N.J. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:LOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-914-1300
Mailing Address - Street 1:67 ROUTE 37 WEST
Mailing Address - Street 2:SUITE I RIVERWOOD II
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755
Mailing Address - Country:US
Mailing Address - Phone:732-914-1300
Mailing Address - Fax:732-914-0849
Practice Address - Street 1:67 ROUTE 37 WEST
Practice Address - Street 2:SUITE I RIVERWOOD II
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-914-1300
Practice Address - Fax:732-914-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03062400208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ005464Medicare ID - Type UnspecifiedGROUP NUMBER