Provider Demographics
NPI:1891740668
Name:BERGEN UROLOGICAL ASSOCIATES,PA
Entity Type:Organization
Organization Name:BERGEN UROLOGICAL ASSOCIATES,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEVEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-342-6600
Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:SUITE 715
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1997
Mailing Address - Country:US
Mailing Address - Phone:201-342-6600
Mailing Address - Fax:201-342-4222
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 715
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:201-342-6600
Practice Address - Fax:201-342-4222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty