Provider Demographics
NPI:1780559138
Name:U.S. UROLOGY NEW JERSEY PRACTICE LLC
Entity type:Organization
Organization Name:U.S. UROLOGY NEW JERSEY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:FADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-616-0293
Mailing Address - Street 1:2 EXECUTIVE CAMPUS
Mailing Address - Street 2:2370 ROUTE 70 SUITE 205
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-4102
Mailing Address - Country:US
Mailing Address - Phone:612-616-0293
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:2 EXECUTIVE CAMPUS
Practice Address - Street 2:2370 ROUTE 70 SUITE 205
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-4102
Practice Address - Country:US
Practice Address - Phone:612-616-0293
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:U.S UROLOGY PARTNERS HOLDINGS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-07
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site