Provider Demographics
NPI:1598283814
Name:HUNTERDON PRIMARY CARE PC
Entity Type:Organization
Organization Name:HUNTERDON PRIMARY CARE PC
Other - Org Name:HUNTERDON MEDICAL ASSOCIATES AT WHITEHOUSE STATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMONTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-284-1125
Mailing Address - Street 1:3 MINNEAKONING RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5726
Mailing Address - Country:US
Mailing Address - Phone:908-284-1125
Mailing Address - Fax:
Practice Address - Street 1:537 US HIGHWAY 22 E FL 3
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3696
Practice Address - Country:US
Practice Address - Phone:908-534-2249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-07
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty