Provider Demographics
NPI:1376248054
Name:DESSALINES, AMBER (APN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:DESSALINES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1684 OLD TRENTON RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3205
Mailing Address - Country:US
Mailing Address - Phone:609-851-3351
Mailing Address - Fax:
Practice Address - Street 1:170 AVENUE AT THE CMN STE 2
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4568
Practice Address - Country:US
Practice Address - Phone:732-747-6600
Practice Address - Fax:732-747-6001
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01466400207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine