Healthcare Provider Details

I. General information

NPI: 1437818085
Provider Name (Legal Business Name): PRINCETON HEALTHCARE PROVIDER GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2021
Last Update Date: 12/15/2021
Certification Date: 12/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOSPITAL DR
PLAINSBORO NJ
08536-2192
US

IV. Provider business mailing address

4 PRINCESS RD STE 207
LAWRENCEVILLE NJ
08648-2322
US

V. Phone/Fax

Practice location:
  • Phone: 609-853-7272
  • Fax:
Mailing address:
  • Phone: 609-243-0445
  • Fax: 609-844-1092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KATHRYN J ROBISON
Title or Position: PRESIDENT
Credential: MD
Phone: 609-853-7220