Healthcare Provider Details

I. General information

NPI: 1730318981
Provider Name (Legal Business Name): RWJ HAMILTON DIABETES & ENDOCRINOLOGY GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2009
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 QUAKERBRIDGE RD STE 2000
HAMILTON NJ
08619-1266
US

IV. Provider business mailing address

3525 QUAKERBRIDGE RD STE 2000
HAMILTON NJ
08619-1266
US

V. Phone/Fax

Practice location:
  • Phone: 609-570-2071
  • Fax: 609-689-2614
Mailing address:
  • Phone: 609-570-2071
  • Fax: 609-689-2614

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL J PERNICE
Title or Position: CFO, SR VP FINANCE
Credential:
Phone: 609-584-6412