Healthcare Provider Details
I. General information
NPI: 1437300803
Provider Name (Legal Business Name): PRINCETON PLAINSBORO OBSTETRICS & GYNECOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2008
Last Update Date: 10/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
601 EWING ST SUITE A4
PRINCETON NJ
08540-2757
US
IV. Provider business mailing address
601 EWING ST SUITE A4
PRINCETON NJ
08540-2757
US
V. Phone/Fax
- Phone: 609-921-1500
- Fax: 609-497-1444
- Phone: 609-921-1500
- Fax: 609-497-1444
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MA02702800 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MA05325900 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | MA03016500 |
| License Number State | NJ |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | MA01767600 |
| License Number State | NJ |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MA 046254 |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
JEFFREY
HOFMAN
Title or Position: ADMINISTRATOR
Credential: M.D.
Phone: 609-921-1500