Provider Demographics
NPI:1336937093
Name:INNOUT UROLOGY OFFICE LLC
Entity type:Organization
Organization Name:INNOUT UROLOGY OFFICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIGON
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:888-433-9360
Mailing Address - Street 1:79 VICARI WAY
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-4041
Mailing Address - Country:US
Mailing Address - Phone:609-857-5275
Mailing Address - Fax:
Practice Address - Street 1:1387 ROUTE 539 UNIT 2C
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-9804
Practice Address - Country:US
Practice Address - Phone:888-433-9360
Practice Address - Fax:609-355-4777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center