Provider Demographics
NPI:1376060285
Name:PRINCETON PERINATAL INSTITUTE
Entity Type:Organization
Organization Name:PRINCETON PERINATAL INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MONDESTIN-SORRENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-620-1774
Mailing Address - Street 1:3131 PRINCETON PIKE BUILDING 6 SUITE 100
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE NJ
Mailing Address - State:NJ
Mailing Address - Zip Code:08648
Mailing Address - Country:US
Mailing Address - Phone:609-620-1774
Mailing Address - Fax:
Practice Address - Street 1:3131 PRINCETON PIKE STE 100
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2201
Practice Address - Country:US
Practice Address - Phone:609-620-1774
Practice Address - Fax:609-620-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty