Provider Demographics
NPI:1912194168
Name:MAHMOOD-SCHOR UROLOGY, P.A.
Entity Type:Organization
Organization Name:MAHMOOD-SCHOR UROLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:V.P.
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:SCHOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-286-6644
Mailing Address - Street 1:20 HOSPITAL DR
Mailing Address - Street 2:SUITE 15
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-6434
Mailing Address - Country:US
Mailing Address - Phone:732-286-6644
Mailing Address - Fax:
Practice Address - Street 1:900 ROUTE 70
Practice Address - Street 2:SUITE 2B
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5940
Practice Address - Country:US
Practice Address - Phone:732-286-6644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03007400174400000X
NJ25MA02823000174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0956406Medicaid
NJ0950106Medicaid
NJ0956406Medicaid