Provider Demographics
NPI:1285357780
Name:ADVANCED UROLOGY ASSOCIATES ENTERPRISES
Entity type:Organization
Organization Name:ADVANCED UROLOGY ASSOCIATES ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:BURZON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-840-4300
Mailing Address - Street 1:595 SHREWSBURY AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-4159
Mailing Address - Country:US
Mailing Address - Phone:732-840-4300
Mailing Address - Fax:
Practice Address - Street 1:446 JACK MARTIN BLVD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-7733
Practice Address - Country:US
Practice Address - Phone:732-840-4300
Practice Address - Fax:733-840-4515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty