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General NPI Number Information
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NPI Number | 1982495412
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Entity Type | Organization
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Legal Business Name | INNOUT UROLOGY HOME LLC
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Dates
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Enumeration Date | 05/14/2025
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 601 WASHINGTON AVE STE J1002
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City | STAFFORD TWP
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State | NJ
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Zip | 08050-2801
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Country | US
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Telephone | 888-433-9360
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Fax | 609-355-4777
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Provider Business Mailing Address
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Address Line | 601 WASHINGTON AVE STE J1002
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City | STAFFORD TWP
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State | NJ
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Zip | 08050-2801
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Country | US
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Telephone | 888-433-9360
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Fax | 609-355-4777
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEO LIGON
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Credential | APN
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Telephone | 888-433-9360
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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