Provider Demographics
NPI:1760436240
Name:SUBURBAN UROLOGIC ASSOCIATES P.C.
Entity Type:Organization
Organization Name:SUBURBAN UROLOGIC ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AILEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-372-6330
Mailing Address - Street 1:2790 MOSSIDE BLVD STE G110
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2766
Mailing Address - Country:US
Mailing Address - Phone:412-372-6330
Mailing Address - Fax:412-372-4291
Practice Address - Street 1:2790 MOSSIDE BLVD STE G110
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2766
Practice Address - Country:US
Practice Address - Phone:412-372-6330
Practice Address - Fax:412-372-4291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD033880E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
038993Medicare ID - Type Unspecified