Provider Demographics
NPI:1467835793
Name:PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Entity Type:Organization
Organization Name:PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Other - Org Name:EWING MEDICAL ASSOCIATES - PRINCETON MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BERGMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:609-853-7220
Mailing Address - Street 1:4 PRINCESS RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2322
Mailing Address - Country:US
Mailing Address - Phone:609-243-0445
Mailing Address - Fax:609-844-1092
Practice Address - Street 1:1539 PENNINGTON RD
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08618-1301
Practice Address - Country:US
Practice Address - Phone:609-883-4124
Practice Address - Fax:609-883-0031
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-06
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty