Provider Demographics
NPI:1104094994
Name:UROLOGICALS PLUS
Entity type:Organization
Organization Name:UROLOGICALS PLUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-728-6171
Mailing Address - Street 1:60 OLD LAKESIDE ROAD SOUTH
Mailing Address - Street 2:
Mailing Address - City:HEWITT
Mailing Address - State:NJ
Mailing Address - Zip Code:07421
Mailing Address - Country:US
Mailing Address - Phone:973-728-6171
Mailing Address - Fax:
Practice Address - Street 1:60 OLD LAKESIDE RD S
Practice Address - Street 2:
Practice Address - City:HEWITT
Practice Address - State:NJ
Practice Address - Zip Code:07421-2821
Practice Address - Country:US
Practice Address - Phone:973-728-6171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJB0000881021332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7002807Medicaid
NJ7002807Medicaid