MEDICARE: TITAN HEALTH PARTNERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician

General Provider Information

NPI Number	:	1023946670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TITAN HEALTH PARTNERS LLC

Provider Business Mailing Address
First Line	:	629 CRANBURY RD FL 2
Second Line	:
City	:	EAST BRUNSWICK
State	:	NJ
Zip	:	08816-4096
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1777 HAMBURG TPKE STE 100
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-5243
Country	:	US
Telephone Number	:	973-616-8400
Fax Number	:

Authorized Official
Title or Position	:	MANAGING PARTNER
Name	:	EDWARD J LICITRA
Credential	:	MD
Telephone Number	:	732-390-7750

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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Directions to “TITAN HEALTH PARTNERS LLC ” Practice Location

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