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Titan Health Partners LLC

Organization Active NPI Hematology & Oncology Physician · Somerset, NJ

NPI 1265623169 · NPPES record last updated Jan 30, 2024

Key facts

NPI
1265623169
Entity type
Organization (NPI type 2)
Primary specialty
Hematology & Oncology Physician 207RH0003X
Legal business name
TITAN HEALTH PARTNERS LLC
Practice address
75 Veronica Ave
Suite 201
Somerset, NJ 08873-5002
Phone
(732) 246-4882
Fax
(732) 249-5633
NPI assigned
Aug 6, 2007
Organization subpart
No

Authorized official

Name
Edward J Licitra, MD, PHD
Title
Ceo/Chairman
Phone
(732) 390-7750

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 99

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 99

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D0125294Titan Health Partners LLC
75 Veronica Ave, Somerset, NJ 08873		ComplianceMar 20, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20210625000721 NJ DME Supplier - Physician - General Practice 3971915349 Practice locations: Somerset, NJ

National Provider Directory

Tax ID family
St Mary Regional Cancer Cen (55 organizations share this tax ID)

Locations

75 Veronica Ave
Ste 201
Somerset, NJ 08873
Phone (732) 246-4882

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 207RH0003X Yes
Durable Medical Equipment & Medical Supplies 332B00000X 5681750001 NJ

Addresses

Primary practice location

75 Veronica Ave
Suite 201
Somerset, NJ 08873-5002

Mailing address

629 Cranbury Rd FL 2
East Brunswick, NJ 08816-4096
Phone (732) 390-7750

Other identifiers

IdentifierTypeStateIssuer
295909OtherNJGROUP MEDICARE NUMBER
1265623169OtherNJGROUP NPI

Other names

  • Astera Cancer Care Doing business as

Other providers in Somerset, NJ

All providers in Somerset, NJ · Hematology & Oncology Physician in New Jersey

Sources for this page

Verify at the official NPI Registry.