Provider Demographics
NPI:1306889084
Name:ASSOCIATES IN PEDIATRIC & ADULT UROLOGY,PA
Entity type:Organization
Organization Name:ASSOCIATES IN PEDIATRIC & ADULT UROLOGY,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBHART
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:973-627-4055
Mailing Address - Street 1:282 ROUTE 46
Mailing Address - Street 2:PO BOX 1160
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834
Mailing Address - Country:US
Mailing Address - Phone:973-627-4055
Mailing Address - Fax:973-627-0750
Practice Address - Street 1:282 ROUTE 46
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834
Practice Address - Country:US
Practice Address - Phone:973-627-4055
Practice Address - Fax:973-627-0750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ526527Medicare ID - Type UnspecifiedGROUP PROVIDER ID