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General NPI Number Information
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NPI Number | 1538116660
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Entity Type | Organization
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Legal Business Name | PAGNANI-BRAGA-KIMMEL UROLOGIC ASSOC, P.A.
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 04/01/2016
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Provider Practice Location Address
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Address Line | 222 NEW ROAD BUILDING 700 CENTRAL PARK EAST
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City | LINWOOD
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State | NJ
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Zip | 08221
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Country | UM
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Telephone | 609-653-4343
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Fax | 609-653-4716
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Provider Business Mailing Address
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Address Line | 222 NEW ROAD BUILDING 700 CENTRAL PARK EAST
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City | LINWOOD
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State | NJ
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Zip | 08221
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Country | UM
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Telephone | 609-653-4343
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Fax | 609-653-4176
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. GAIL MARIE SIMERSON
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Credential |
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Telephone | 609-653-4343
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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