Healthcare Provider Details

I. General information

NPI: 1952218513
Provider Name (Legal Business Name): TITAN HEALTH PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 OVERLOOK RD STE 230
SUMMIT NJ
07901-3580
US

IV. Provider business mailing address

629 CRANBURY RD FL 2
EAST BRUNSWICK NJ
08816-4096
US

V. Phone/Fax

Practice location:
  • Phone: 973-828-4300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: EDWARD J LICITRA
Title or Position: CEO
Credential: MD
Phone: 732-390-7750