Provider Demographics
NPI:1205977170
Name:ALLIED UROLOGY ASSOCIATES, INC.
Entity type:Organization
Organization Name:ALLIED UROLOGY ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:F
Authorized Official - Last Name:MIZIKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:814-452-4214
Mailing Address - Street 1:311 W 24TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16502-2665
Mailing Address - Country:US
Mailing Address - Phone:814-452-4214
Mailing Address - Fax:814-461-8424
Practice Address - Street 1:311 W 24TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16502-2665
Practice Address - Country:US
Practice Address - Phone:814-452-4214
Practice Address - Fax:814-459-7823
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty