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General NPI Number Information
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NPI Number | 1265635627
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Entity Type | Organization
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Legal Business Name | ATLANTIC COAST UROLOGY,PA
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 1944 STATE ROUTE 33 SUITE 101
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City | NEPTUNE
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State | NJ
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Zip | 07753-4862
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Country | US
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Telephone | 732-775-8444
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Fax | 732-775-8550
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Provider Business Mailing Address
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Address Line | 1944 CORLIES AVE SUITE 101
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City | NEPTUNE
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State | NJ
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Zip | 07753-4862
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Country | US
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Telephone | 732-775-8444
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Fax | 732-775-8550
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW STEVEN TOBIN
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Credential | MD
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Telephone | 732-775-8444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 25MA63814
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License Number State | NJ
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