Healthcare Provider Details

I. General information

NPI: 1952289332
Provider Name (Legal Business Name): SAINT PETER'S UNIVERSITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

562 EASTON AVE STE B
SOMERSET NJ
08873-1900
US

IV. Provider business mailing address

254 EASTON AVE
NEW BRUNSWICK NJ
08901-1766
US

V. Phone/Fax

Practice location:
  • Phone: 732-745-6649
  • Fax: 732-342-1414
Mailing address:
  • Phone: 732-745-6649
  • Fax: 732-342-1414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STACEY KNOWLES
Title or Position: DIRECTOR PAYER RELATIONS
Credential:
Phone: 732-565-5453