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NPI Code Detail

MEDICARE: TITAN HEALTH PARTNERS LLC

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
1207RH0003XHematology & Oncology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
16682390003OTHERNJNSC DMERC ID#
26682390003OTHERNJNSC-DMERC

General Provider Information

NPI Number : 1528125333
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 : 732-390-7750
Fax Number : 732-390-7725
Provider Business Practice Location Address
First Line : 629 CRANBURY RD FL 2
Second Line :
City : EAST BRUNSWICK
State : NJ
Zip : 08816-4096
Country : US
Telephone Number : 732-390-7750
Fax Number : 732-390-7725
Authorized Official
Title or Position : CEO/CHAIRMAN
Name : EDWARD J LICITRA
Credential : MD, PHD
Telephone Number : 732-390-7750
Provider Enumeration Date : 01/02/2007
Last Update Date : 01/30/2024

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Directions to “TITAN HEALTH PARTNERS LLC ” Practice Location

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