Provider Demographics
NPI:1922696228
Name:EMPIRE UROLOGY LLC
Entity Type:Organization
Organization Name:EMPIRE UROLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:ISRAELI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-251-2055
Mailing Address - Street 1:349 E NORTHFIELD RD STE 202
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4806
Mailing Address - Country:US
Mailing Address - Phone:973-251-2055
Mailing Address - Fax:973-251-2562
Practice Address - Street 1:349 E NORTHFIELD RD STE 202
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4806
Practice Address - Country:US
Practice Address - Phone:973-251-2055
Practice Address - Fax:973-251-2562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-04
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Single Specialty