Provider Demographics
NPI: | 1518194323 |
---|---|
Name: | PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC |
Entity Type: | Organization |
Organization Name: | PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC |
Other - Org Name: | PRINCETON HEALTHCARE MEDICAL ASSOCIATES |
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: | 609-734-7601 |
Mailing Address - Fax: | 609-844-1092 |
Practice Address - Street 1: | 5 PLAINSBORO ROAD |
Practice Address - Street 2: | SUITE 300 |
Practice Address - City: | PLAINSBORO |
Practice Address - State: | NJ |
Practice Address - Zip Code: | 08536-1915 |
Practice Address - Country: | US |
Practice Address - Phone: | 609-853-7272 |
Practice Address - Fax: | 609-853-7271 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2009-06-18 |
Last Update Date: | 2020-11-16 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207RG0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | Group - Multi-Specialty |
No | 207RH0002X | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
No | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care | Group - Multi-Specialty |
No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |