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NPI Code Detail

MEDICARE: PRINCETON HYPERTENSION NEPHROLOGY ASSOCIATES LLC

MEDICARE: PRINCETON HYPERTENSION NEPHROLOGY ASSOCIATES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistNJ

General Provider Information

NPI Number : 1639124480
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRINCETON HYPERTENSION NEPHROLOGY ASSOCIATES LLC
Provider Business Mailing Address
First Line : 88 PRINCETON HIGHTSTOWN RD
Second Line : SUITE 203
City : PRINCETON JUNCTION
State : NJ
Zip : 08550-1100
Country : US
Telephone Number : 609-750-7330
Fax Number : 609-750-7336
Provider Business Practice Location Address
First Line : 88 PRINCETON HIGHTSTOWN RD
Second Line : SUITE 203
City : PRINCETON JUNCTION
State : NJ
Zip : 08550-1100
Country : US
Telephone Number : 609-750-7330
Fax Number : 609-750-7336
Authorized Official
Title or Position : MANAGING PHYSICIAN
Name : DR. MICHAEL C RUDDY
Credential : MD
Telephone Number : 609-750-7330
Provider Enumeration Date : 05/23/2006
Last Update Date : 06/24/2008

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Directions to “PRINCETON HYPERTENSION NEPHROLOGY ASSOCIATES LLC ” Practice Location

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