Healthcare Provider Details
I. General information
NPI: 1861721474
Provider Name (Legal Business Name): PRINCETON HEALTHCARE AFFILIATED PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/10/2009
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 PLAINSBORO RD
PLAINSBORO NJ
08536-1913
US
IV. Provider business mailing address
4 PRINCESS RD SUITE 207
LAWRENCEVILLE NJ
08648-2322
US
V. Phone/Fax
- Phone: 609-853-7000
- Fax:
- Phone: 609-734-7601
- Fax: 609-844-1092
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AS0400X |
| Taxonomy | Surgical Physician Assistant |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KATHRYN
J
ROBISON
Title or Position: PRESIDENT
Credential: MD
Phone: 609-853-7232