Provider Demographics
NPI:1548761695
Name:PRINCETON INTEGRATIVE HEALTH
Entity Type:Organization
Organization Name:PRINCETON INTEGRATIVE HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:LEONTI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-512-1468
Mailing Address - Street 1:134 FRANKLIN CORNER RD STE 101B
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2527
Mailing Address - Country:US
Mailing Address - Phone:609-512-1468
Mailing Address - Fax:609-512-1546
Practice Address - Street 1:134 FRANKLIN CORNER RD STE 101B
Practice Address - Street 2:
Practice Address - City:LAWRENCE TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08648-2527
Practice Address - Country:US
Practice Address - Phone:609-512-1468
Practice Address - Fax:609-512-1546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA099128002083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty