Provider Demographics
NPI:1417985391
Name:PRINCIPE, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:PRINCIPE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 BROADWAY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-1842
Mailing Address - Country:US
Mailing Address - Phone:973-569-6264
Mailing Address - Fax:973-569-6270
Practice Address - Street 1:1 BROADWAY
Practice Address - Street 2:SUITE 203
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-1842
Practice Address - Country:US
Practice Address - Phone:973-569-6264
Practice Address - Fax:973-569-6270
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-29
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06339800207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA06339800OtherMEDICAL LICENSE
NJ25MA06339800OtherMEDICAL LICENSE