Provider Demographics
NPI:1821066226
Name:FAMILY PHICIANS OF HUNTERDON COUNTY
Entity Type:Organization
Organization Name:FAMILY PHICIANS OF HUNTERDON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:VALES
Authorized Official - Last Name:CARRUTH MEHNERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-788-5093
Mailing Address - Street 1:2150 WESCOTT DR
Mailing Address - Street 2:APT 10
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4644
Mailing Address - Country:US
Mailing Address - Phone:908-788-5093
Mailing Address - Fax:
Practice Address - Street 1:403 HIGHWAY 202
Practice Address - Street 2:SUITE 100
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-6037
Practice Address - Country:US
Practice Address - Phone:908-788-7846
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07779600170100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes170100000XOther Service ProvidersMedical Genetics, Ph.D. Medical GeneticsGroup - Multi-Specialty