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General NPI Number Information
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NPI Number | 1528112042
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Entity Type | Organization
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Legal Business Name | PRINCETON EAR NOSE & THROAT PC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | MEDICAL ARTS BLDG STE S 253 WITHERSPOON ST
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City | PRINCETON
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State | NJ
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Zip | 08540-3211
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Country | US
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Telephone | 609-921-8800
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Fax | 609-921-1761
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Provider Business Mailing Address
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Address Line | MEDICAL ARTS BLDG STE S 253 WITHERSPOON ST
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City | PRINCETON
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State | NJ
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Zip | 08540-3211
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Country | US
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Telephone | 609-921-8800
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Fax | 609-921-1761
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID GOLDFARB
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Credential | DO FACS
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Telephone | 609-921-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | MB051472NJ
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License Number State | NJ
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