Provider Demographics
NPI:1710029046
Name:PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION
Entity Type:Organization
Organization Name:PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION
Other - Org Name:MERWICK REHAB HOSPITAL & NURSING CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-497-4107
Mailing Address - Street 1:79 BAYARD LN
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3045
Mailing Address - Country:US
Mailing Address - Phone:609-497-3000
Mailing Address - Fax:
Practice Address - Street 1:79 BAYARD LN
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3045
Practice Address - Country:US
Practice Address - Phone:609-497-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5750695OtherAETNA MERWICK SNF
NJ000753OtherHORIZON MEDI MERWICK SNF
NJ4482808Medicaid
NJ000753OtherHORIZON MEDI MERWICK SNF
NJ315001Medicare Oscar/Certification