Provider Demographics
NPI:1669030250
Name:PRINCETON INTERNAL MEDICINE AND GERIATRICS LLC
Entity Type:Organization
Organization Name:PRINCETON INTERNAL MEDICINE AND GERIATRICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ERINN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BEAGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-319-0713
Mailing Address - Street 1:5 NANCY ST
Mailing Address - Street 2:
Mailing Address - City:KENDALL PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08824-1652
Mailing Address - Country:US
Mailing Address - Phone:732-319-0713
Mailing Address - Fax:
Practice Address - Street 1:800 BUNN DR STE 302
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1968
Practice Address - Country:US
Practice Address - Phone:732-319-0713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty