Healthcare Provider Details

I. General information

NPI: 1578855177
Provider Name (Legal Business Name): PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2011
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HERRONTOWN RD CLOCK BUILDING
PRINCETON NJ
08540-7716
US

IV. Provider business mailing address

4 PRINCESS RD SUITE 207
LAWRENCEVILLE NJ
08648-2322
US

V. Phone/Fax

Practice location:
  • Phone: 877-443-7085
  • Fax: 609-683-5910
Mailing address:
  • Phone: 609-234-0445
  • Fax: 609-844-1092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN R BERGMANN
Title or Position: PRESIDENT
Credential: MD PHD
Phone: 609-853-7220