Provider Demographics
NPI:1770607996
Name:PRINCETON OSTEOPOROSIS CENTER PA
Entity type:Organization
Organization Name:PRINCETON OSTEOPOROSIS CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:J
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:609-921-3331
Mailing Address - Street 1:281 WITHERSPOON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3210
Mailing Address - Country:US
Mailing Address - Phone:609-921-3331
Mailing Address - Fax:609-252-0722
Practice Address - Street 1:281 WITHERSPOON ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3210
Practice Address - Country:US
Practice Address - Phone:609-921-3331
Practice Address - Fax:609-252-0722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23612174400000X
207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD19874Medicare UPIN