Healthcare Provider Details

I. General information

NPI: 1316314859
Provider Name (Legal Business Name): PRINCETON HEALTHCARE PROVIDER GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2015
Last Update Date: 09/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PLAINSBORO RD 6TH FLOOR
PLAINSBORO NJ
08536-1913
US

IV. Provider business mailing address

4 PRINCESS RD STE 207
LAWRENCEVILLE NJ
08648-2322
US

V. Phone/Fax

Practice location:
  • Phone: 609-853-7276
  • Fax:
Mailing address:
  • Phone: 609-243-0445
  • Fax: 609-844-1092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DONALD F DENNY
Title or Position: PRESIDENT
Credential: MD
Phone: 609-853-7108