Provider Demographics
NPI:1821222753
Name:ADVANCED UROLOGIC CARE ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:ADVANCED UROLOGIC CARE ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-324-0103
Mailing Address - Street 1:443 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-3093
Mailing Address - Country:US
Mailing Address - Phone:973-324-0103
Mailing Address - Fax:973-718-4611
Practice Address - Street 1:443 NORTHFIELD AVE
Practice Address - Street 2:SUITE 201A
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-3093
Practice Address - Country:US
Practice Address - Phone:973-324-0103
Practice Address - Fax:973-718-4611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA62364208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty