Healthcare Provider Details

I. General information

NPI: 1770541534
Provider Name (Legal Business Name): HIGHTSTOWN MEDICAL ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 12/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 PRINCETON HIGHTSTOWN RD BLDG. 3 A SUITE 101
WEST WINDSOR NJ
08550-1668
US

IV. Provider business mailing address

186 PRINCETON HIGHTSTOWN RD BLDG.3 A SUITE 101
WEST WINDSOR NJ
08550-1668
US

V. Phone/Fax

Practice location:
  • Phone: 609-443-1150
  • Fax: 609-799-9005
Mailing address:
  • Phone: 609-443-1150
  • Fax: 609-799-9005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. SUSAN ELEANOR MAUGERI
Title or Position: PRACTICE MANAGER
Credential: LPN AAS
Phone: 609-443-1150