Healthcare Provider Details

I. General information

NPI: 1619267788
Provider Name (Legal Business Name): COMPASS MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 DENOW RD C382
PENNINGTON NJ
08534-5246
US

IV. Provider business mailing address

4065 QUAKERBRIDGE RD SUITE 102
PRINCETON JUNCTION NJ
08550-5243
US

V. Phone/Fax

Practice location:
  • Phone: 609-613-2226
  • Fax:
Mailing address:
  • Phone: 609-613-2226
  • Fax: 609-482-3701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: TOM BELL
Title or Position: PRESIDENT
Credential:
Phone: 609-613-2226