Healthcare Provider Details

I. General information

NPI: 1548761695
Provider Name (Legal Business Name): PRINCETON INTEGRATIVE HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2018
Last Update Date: 02/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 FRANKLIN CORNER RD STE 101B
LAWRENCE TOWNSHIP NJ
08648-2527
US

IV. Provider business mailing address

134 FRANKLIN CORNER RD STE 101B
LAWRENCE TOWNSHIP NJ
08648-2527
US

V. Phone/Fax

Practice location:
  • Phone: 609-512-1468
  • Fax: 609-512-1546
Mailing address:
  • Phone: 609-512-1468
  • Fax: 609-512-1546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number25MA09912800
License Number StateNJ

VIII. Authorized Official

Name: DR. VINCENT JOSEPH LEONTI
Title or Position: CO-OWNER
Credential: MD
Phone: 609-512-1468