Provider Demographics
NPI:1821048307
Name:VAN HOVEN, ANNE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:VAN HOVEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 EASTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1766
Mailing Address - Country:US
Mailing Address - Phone:732-745-6667
Mailing Address - Fax:732-249-0969
Practice Address - Street 1:254 EASTON AVE
Practice Address - Street 2:CARES BLDG, 4TH FLOOR
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1766
Practice Address - Country:US
Practice Address - Phone:732-745-6667
Practice Address - Fax:732-249-0969
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2017-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA73828207R00000X
NJ25MA7382800207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP00141973OtherRAILROAD MEDICARE
NJ0042463Medicaid
NJ084512B3LMedicare ID - Type Unspecified
NJI19240Medicare UPIN