Healthcare Provider Details

I. General information

NPI: 1689142093
Provider Name (Legal Business Name): PRIMARY CARE OF MERCER AND MONMOUTH COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 11/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1374 WHITEHORSE HAMILTON SQUARE RD STE 304
HAMILTON NJ
08690-3701
US

IV. Provider business mailing address

1374 WHITEHORSE HAMILTON SQUARE RD STE 304
HAMILTON NJ
08690-3701
US

V. Phone/Fax

Practice location:
  • Phone: 609-838-7111
  • Fax:
Mailing address:
  • Phone: 609-838-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CARRIE LIMING
Title or Position: CO-OWNER
Credential: APN-C
Phone: 609-838-7111