Provider Demographics
NPI:1558641126
Name:PRINCETON PROCURE MANAGEMENT, LLC
Entity Type:Organization
Organization Name:PRINCETON PROCURE MANAGEMENT, LLC
Other - Org Name:PROCURE PROTON THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:HSIN-CHIEH
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-357-2600
Mailing Address - Street 1:PO BOX 872658
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64187-2658
Mailing Address - Country:US
Mailing Address - Phone:732-357-2600
Mailing Address - Fax:
Practice Address - Street 1:103 CEDAR GROVE LN
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-4717
Practice Address - Country:US
Practice Address - Phone:732-357-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-26
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA085854002085R0001X
261QX0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0203XAmbulatory Health Care FacilitiesClinic/CenterOncology, Radiation
No2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation OncologyGroup - Multi-Specialty