Urologic Associates of Wilkes Barre Inc

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

UROLOGIC ASSOCIATES OF WILKES BARRE INC

Practice address

470 Wyoming Ave
Kingston, PA 18704-3603

Phone

(570) 288-4551

Fax

(570) 287-7999

NPI assigned

Jun 1, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Haragopal Penugonda, MD

Title

Owner

Phone

(570) 288-4551

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043412265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043603",
            "telephone_number": "570-288-4551",
            "fax_number": "570-287-7999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 WYOMING AVE",
            "city": "KINGSTON",
            "state": "PA",
            "postal_code": "187043603",
            "telephone_number": "570-288-4551",
            "fax_number": "570-287-7999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGIC ASSOCIATES OF WILKES BARRE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PENUGONDA",
        "authorized_official_first_name": "HARAGOPAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-288-4551",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Andrew Tricarico, DO
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• Candice Van Etten, CRVT

• Urology Physician in Kingston, PA
• Providers in Kingston, PA by specialty
• Urology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.