Healthcare Provider Details

I. General information

NPI: 1518194307
Provider Name (Legal Business Name): PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 FEDERAL CITY RD
LAWRENCEVILLE NJ
08648-1664
US

IV. Provider business mailing address

4 PRINCESS RD SUITE 207
LAWRENCEVILLE NJ
08648-2322
US

V. Phone/Fax

Practice location:
  • Phone: 609-620-1380
  • Fax: 609-771-8991
Mailing address:
  • Phone: 609-734-7601
  • 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