Provider Demographics
NPI:1548604697
Name:PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Entity Type:Organization
Organization Name:PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Other - Org Name:REDNOR-RISI FAMILY MEDICINE - 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:
Practice Address - Street 1:1 WASHINGTON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-3162
Practice Address - Country:US
Practice Address - Phone:609-448-4353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-19
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty