Healthcare Provider Details

I. General information

NPI: 1376685297
Provider Name (Legal Business Name): PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 04/13/2023
Certification Date: 04/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 COLLEGE RD E FL 2
PRINCETON NJ
08540-6622
US

IV. Provider business mailing address

105 COLLEGE RD E FL 2
PRINCETON NJ
08540-6622
US

V. Phone/Fax

Practice location:
  • Phone: 609-497-4900
  • Fax: 609-497-4933
Mailing address:
  • Phone: 609-497-4900
  • Fax: 609-497-4933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number StateNJ

VIII. Authorized Official

Name: MR. GUILHERME SIMOES VALLADARES
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 609-853-7112