Healthcare Provider Details

I. General information

NPI: 1710087895
Provider Name (Legal Business Name): HUNTINGTON UROLOGICAL ASSOC, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 THIRD AVENUE SUITE 230
HUNTINGTON WV
25702-1453
US

IV. Provider business mailing address

2860 3RD AVE STE 230
HUNTINGTON WV
25702-1453
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-3711
  • Fax: 304-525-2748
Mailing address:
  • Phone: 304-525-3711
  • Fax: 304-525-2748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. ROCCO A MORABITO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 304-525-3711