Provider Demographics
NPI:1457618415
Name:UROLOGIC SOLUTIONS ,LLC
Entity Type:Organization
Organization Name:UROLOGIC SOLUTIONS ,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAZA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-826-0059
Mailing Address - Street 1:663 BRACE AVE
Mailing Address - Street 2:
Mailing Address - City:PERTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08861-3027
Mailing Address - Country:US
Mailing Address - Phone:732-826-0059
Mailing Address - Fax:732-826-6576
Practice Address - Street 1:663 BRACE AVE
Practice Address - Street 2:
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3027
Practice Address - Country:US
Practice Address - Phone:732-826-0059
Practice Address - Fax:732-826-6576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-16
Last Update Date:2012-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03807500302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization