Provider Demographics
NPI:1730318981
Name:RWJ HAMILTON DIABETES & ENDOCRINOLOGY GROUP PA
Entity Type:Organization
Organization Name:RWJ HAMILTON DIABETES & ENDOCRINOLOGY GROUP PA
Other - Org Name:RWJ HAMILTON VASCULAR SURGERY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO, SR VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:PERNICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-584-6412
Mailing Address - Street 1:3525 QUAKERBRIDGE RD STE 2000
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1266
Mailing Address - Country:US
Mailing Address - Phone:609-570-2071
Mailing Address - Fax:609-689-2614
Practice Address - Street 1:3525 QUAKERBRIDGE RD STE 2000
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1266
Practice Address - Country:US
Practice Address - Phone:609-570-2071
Practice Address - Fax:609-689-2614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty