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General NPI Number Information
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NPI Number | 1194690065
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Entity Type | Organization
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Legal Business Name | TITAN HEALTH PARTNERS LLC
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Dates
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Enumeration Date | 10/09/2025
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 4 PROGRESS ST STE A9
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City | EDISON
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State | NJ
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Zip | 08820-1199
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Country | US
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Telephone | 732-724-3070
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Fax |
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Provider Business Mailing Address
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Address Line | 629 CRANBURY RD FL 2
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-4096
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Country | US
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Telephone | 732-390-7725
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EDWARD J LICITRA
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Credential | MD
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Telephone | 732-390-7750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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