Provider Demographics
NPI:1861547044
Name:ROTOLO HOWARD & LEITNER UROLOGICAL ASSOCIATES PA
Entity type:Organization
Organization Name:ROTOLO HOWARD & LEITNER UROLOGICAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:ROTOLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-223-7877
Mailing Address - Street 1:2401 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1101
Mailing Address - Country:US
Mailing Address - Phone:732-223-7877
Mailing Address - Fax:732-223-7151
Practice Address - Street 1:2401 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1101
Practice Address - Country:US
Practice Address - Phone:732-223-7877
Practice Address - Fax:732-223-7151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0731660001OtherDMERC GRP ID NUMBER
NJ901572Medicare ID - Type UnspecifiedGROUP ID NUMBER