Healthcare Provider Details

I. General information

NPI: 1023493806
Provider Name (Legal Business Name): PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 11/27/2023
Certification Date: 10/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 AMWELL RD STE 405
HILLSBOROUGH NJ
08844-1247
US

IV. Provider business mailing address

4 PRINCESS RD STE 207
LAWRENCEVILLE NJ
08648-2322
US

V. Phone/Fax

Practice location:
  • Phone: 908-281-1199
  • Fax: 908-281-4311
Mailing address:
  • Phone: 609-243-0445
  • Fax: 609-844-1092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN R BERGMANN
Title or Position: PRESIDENT
Credential:
Phone: 609-853-7220