Healthcare Provider Details

I. General information

NPI: 1457215337
Provider Name (Legal Business Name): US UROLOGY NEW JERSEY PRACTICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 ROUTE 73 SUITE A AND B
VOORHEES NJ
08043-9598
US

IV. Provider business mailing address

136 ROUTE 73 SUITE A AND B
VOORHEES NJ
08043-9598
US

V. Phone/Fax

Practice location:
  • Phone: 901-604-7707
  • Fax:
Mailing address:
  • Phone: 901-604-7707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: RONALD SANGWON SUH
Title or Position: SOLE MEMBER
Credential: M.D.
Phone: 901-604-7707