Provider Demographics
NPI:1316728892
Name:TITAN HEALTH PARTNERS LLC
Entity type:Organization
Organization Name:TITAN HEALTH PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER / CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LICITRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-390-7750
Mailing Address - Street 1:TITAN HEALTH PARTNERS, LLC
Mailing Address - Street 2:629 CRANBURY RD FL 2
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4096
Mailing Address - Country:US
Mailing Address - Phone:732-390-7750
Mailing Address - Fax:732-390-7725
Practice Address - Street 1:579A CRANBURY RD STE 103
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5426
Practice Address - Country:US
Practice Address - Phone:732-724-3070
Practice Address - Fax:732-853-7422
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TITAN HEALTH PARTNERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-10
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty