Organization
PREMIER UROLOGY GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN FAND MD (MD)
(732) 679-2010
Entity
Organization
Contact information
Practice address
3 HOSPITAL PLZ, SUITE 200, OLD BRIDGE, NJ 08857-3093
(732) 679-2010
Mailing address
3 HOSPITAL PLZ, SUITE 200, OLD BRIDGE, NJ 08857-3093
(732) 679-2010
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA05567600
NJ
Other
Enumeration date
03/01/2010
Last updated
08/17/2010
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