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General NPI Number Information
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NPI Number | 1780559138
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Entity Type | Organization
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Legal Business Name | U.S. UROLOGY NEW JERSEY PRACTICE LLC
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 2 EXECUTIVE CAMPUS 2370 ROUTE 70 SUITE 205
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City | CHERRY HILL
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State | NJ
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Zip | 08002-4102
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Country | US
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Telephone | 612-616-0293
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Fax | --
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Provider Business Mailing Address
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Address Line | 2 EXECUTIVE CAMPUS 2370 ROUTE 70 SUITE 205
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City | CHERRY HILL
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State | NJ
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Zip | 08002-4102
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Country | US
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Telephone | 612-616-0293
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Fax | --
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Authorized Official
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Title or Position | VP OF PHARMACY
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Name | AMANDA FADDEN
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Credential |
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Telephone | 612-616-0293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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