Provider Demographics
NPI:1205218971
Name:BANCROFT, A NEW JERSEY NONPROFIT CORPORATION
Entity Type:Organization
Organization Name:BANCROFT, A NEW JERSEY NONPROFIT CORPORATION
Other - Org Name:BANCROFT-PLAINSBORO
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CRIPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-348-1196
Mailing Address - Street 1:1255 CALDWELL ROAD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034
Mailing Address - Country:US
Mailing Address - Phone:856-348-4011
Mailing Address - Fax:856-216-1269
Practice Address - Street 1:666 PLAINSBORO ROAD SUITE 2000C
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536
Practice Address - Country:US
Practice Address - Phone:732-206-1577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ=========Medicaid
NJ0016501Medicare PIN