Healthcare Provider Details

I. General information

NPI: 1982840013
Provider Name (Legal Business Name): HVR ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2008
Last Update Date: 02/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 EWING ST SUITE B 19
PRINCETON NJ
08540-2757
US

IV. Provider business mailing address

601 EWING ST SUITE B 19
PRINCETON NJ
08540-2757
US

V. Phone/Fax

Practice location:
  • Phone: 609-924-2230
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: HEATHER M VAN RAALTE
Title or Position: MD
Credential:
Phone: 609-924-2230