Provider Demographics
NPI:1063841922
Name:PRIMARY CARE NJ LLC
Entity Type:Organization
Organization Name:PRIMARY CARE NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIMARY CARE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SAGAR
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-635-1600
Mailing Address - Street 1:74 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540
Mailing Address - Country:US
Mailing Address - Phone:732-547-0258
Mailing Address - Fax:
Practice Address - Street 1:98 JAMES STREET SUITE 313
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820
Practice Address - Country:US
Practice Address - Phone:732-635-1600
Practice Address - Fax:732-635-1402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-01
Last Update Date:2013-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07096500261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care