Provider Demographics
NPI:1619151933
Name:BOROUGH OF PRINCETON
Entity Type:Organization
Organization Name:BOROUGH OF PRINCETON
Other - Org Name:BOROUGH OF PRINCETON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:609-497-7610
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:1 MONUMENT DRIVE
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-0001
Mailing Address - Country:US
Mailing Address - Phone:609-497-7608
Mailing Address - Fax:609-924-7627
Practice Address - Street 1:1 MONUMENT DRIVE
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-0001
Practice Address - Country:US
Practice Address - Phone:609-497-7608
Practice Address - Fax:609-924-7627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ181537Medicare PIN