Healthcare Provider Details

I. General information

NPI: 1154353902
Provider Name (Legal Business Name): PRINCETON INTERVENTIONAL CARDIOLOGY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 WALL ST
PRINCETON NJ
08540-1516
US

IV. Provider business mailing address

389 WALL ST STE 101
PRINCETON NJ
08540-1516
US

V. Phone/Fax

Practice location:
  • Phone: 609-921-2800
  • Fax: 609-921-3499
Mailing address:
  • Phone: 609-921-2800
  • Fax: 609-921-3499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES R BEATTIE III
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 609-921-2800