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Organization

OCEAN UROLOGY GROUP PA.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WALTER EMMETT LEWIS III M.D. (DOCTOR)
(732) 349-5200
Entity
Organization

Contact information

Practice address
780 RTE 37 W, SUITE 100, TOMS RIVER, NJ 08755-5059
(732) 349-5200
(732) 349-5235
Mailing address
780 ROUTE 37 WEST, SUITE 100, TOMS RIVER, NJ 08755-6434
(732) 349-5200
(732) 349-5235

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0721400010
RAILROAD MEDICARE
GA
05
2643006
NJ
Enumeration date
09/20/2007
Last updated
06/23/2011
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