Provider Demographics
NPI:1932132933
Name:HUNTERDON MEDICAL CENTER
Entity Type:Organization
Organization Name:HUNTERDON MEDICAL CENTER
Other - Org Name:ADVANCED GASTROENTEROLOGY AND NUTRITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HOSKINS
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:908-788-6429
Mailing Address - Street 1:1100 WESCOTT DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4600
Mailing Address - Country:US
Mailing Address - Phone:908-788-4022
Mailing Address - Fax:908-788-4066
Practice Address - Street 1:1100 WESCOTT DR
Practice Address - Street 2:SUITE 201
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4600
Practice Address - Country:US
Practice Address - Phone:908-788-4022
Practice Address - Fax:908-788-4066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA49332207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0198234Medicaid
NJ153028Medicare PIN