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General NPI Number Information
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NPI Number | 1396041844
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Entity Type | Organization
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Legal Business Name | THE OTHER WAY
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Dates
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Enumeration Date | 02/01/2011
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 923 CHERRY HILL RD
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City | PRINCETON
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State | NJ
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Zip | 08540-7711
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Country | US
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Telephone | 609-466-2563
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Fax | 609-466-0676
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Provider Business Mailing Address
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Address Line | 923 CHERRY HILL RD
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City | PRINCETON
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State | NJ
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Zip | 08540-7711
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Country | US
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Telephone | 609-466-2563
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Fax | 609-466-0676
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | BARBARA BRUNET HAMDAN
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Credential | M.D.
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Telephone | 609-466-2563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MAO2029400
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License Number State | NJ
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