Organization
UROLOGICAL SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROLD GRUBMAN 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
10 PARSONAGE RD, SUITE 118, EDISON, NJ 08837-2429
(732) 494-9400
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA02705000
NJ
174400000X
Specialist
25MA03473500
NJ
174400000X
Specialist
25MA04379500
NJ
174400000X
Specialist
25MA05771900
NJ
174400000X
Specialist
25MA07259700
NJ
174400000X
Specialist
Primary
25MA07737800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0563141
AETNA HMO GROUP #
NJ
01
—
4229622
AETNA PPO GROUP #
NJ
01
—
5739960001
DME OLD BRIDGE
NJ
01
—
5739960002
DME EDISON
NJ
01
—
CB7278
RAILROAD MEDICARE GROUP #
NJ
Enumeration date
10/04/2006
Last updated
04/20/2008
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