Provider Demographics
NPI:1609913037
Name:PRINCETON SURGIPLEX LLC
Entity Type:Organization
Organization Name:PRINCETON SURGIPLEX LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDINO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:609-921-3440
Mailing Address - Street 1:932 STATE RD
Mailing Address - Street 2:STE H
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1445
Mailing Address - Country:US
Mailing Address - Phone:609-921-3440
Mailing Address - Fax:609-924-7440
Practice Address - Street 1:932 STATE RD
Practice Address - Street 2:STE H
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1445
Practice Address - Country:US
Practice Address - Phone:609-921-3440
Practice Address - Fax:609-924-7440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ059769Medicare PIN