Provider Demographics
NPI:1639654106
Name:PRINCETON ENT AND SLEEP LLC
Entity Type:Organization
Organization Name:PRINCETON ENT AND SLEEP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:D
Authorized Official - Last Name:SUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-921-8800
Mailing Address - Street 1:3327 IDAHO AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3737
Mailing Address - Country:US
Mailing Address - Phone:914-262-3798
Mailing Address - Fax:
Practice Address - Street 1:10 FORRESTAL RD S STE 206
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6666
Practice Address - Country:US
Practice Address - Phone:609-921-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA08694400OtherNJ MEDICAL LICENSE