Provider Demographics
NPI:1528097193
Name:UROLOGY PARTNERS, LLC
Entity type:Organization
Organization Name:UROLOGY PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:CWIKLINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-941-2910
Mailing Address - Street 1:18099 LORAIN AVE
Mailing Address - Street 2:SUITE 141
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111-5610
Mailing Address - Country:US
Mailing Address - Phone:216-941-0333
Mailing Address - Fax:216-941-5257
Practice Address - Street 1:18099 LORAIN AVE
Practice Address - Street 2:SUITE 141
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-5610
Practice Address - Country:US
Practice Address - Phone:216-941-0333
Practice Address - Fax:216-941-1071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHDD4704OtherRAILROAD MEDICARE
OH0826057Medicaid
OH9354701Medicare PIN