Provider Demographics
NPI:1316959125
Name:ASSOCIATED UROLOGISTS LLC
Entity type:Organization
Organization Name:ASSOCIATED UROLOGISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:S
Authorized Official - Last Name:TOMASZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-364-1664
Mailing Address - Street 1:1255 HIGHWAY 70
Mailing Address - Street 2:SUITE 33S
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5973
Mailing Address - Country:US
Mailing Address - Phone:732-364-1664
Mailing Address - Fax:732-364-1667
Practice Address - Street 1:1255 HIGHWAY 70
Practice Address - Street 2:SUITE 33S
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5900
Practice Address - Country:US
Practice Address - Phone:732-364-1664
Practice Address - Fax:732-364-1667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07964400208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJDCN2263OtherRAILROAD MEDICARE NUMBER
NJ103824Medicare UPIN