Provider Demographics
NPI:1376245753
Name:ESSENTIAL DIAGNOSTICS, P.A.
Entity Type:Organization
Organization Name:ESSENTIAL DIAGNOSTICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JADEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KWAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-789-3139
Mailing Address - Street 1:301 CARNEGIE CTR STE 300
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6588
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 FORRESTAL RD S
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6658
Practice Address - Country:US
Practice Address - Phone:732-789-3139
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-20
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty