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General NPI Number Information
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NPI Number | 1861669244
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Entity Type | Organization
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Legal Business Name | PRINCETON ROAD PEDIATRICS, PA
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Dates
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Enumeration Date | 05/14/2008
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Last Update Date | 03/20/2015
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Provider Practice Location Address
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Address Line | 251 PRINCETON HIGHTSTOWN ROAD SUITE 4
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City | EAST WINDSOR
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State | NJ
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Zip | 08520
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Country | US
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Telephone | 609-448-8280
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Fax | 609-395-1978
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Provider Business Mailing Address
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Address Line | 251 PRINCETON HIGHTSTOWN ROAD SUITE 4
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City | EAST WINDSOR
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State | NJ
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Zip | 08520
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Country | US
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Telephone | 609-448-8280
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Fax | 609-395-1978
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Authorized Official
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Title or Position | SITE/BILLING MANAGER
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Name | MS. DENISE ALICIA GARCIA
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Credential |
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Telephone | 609-448-8280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | MA015133
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 25MA03948900
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 25MA03948900
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License Number State | NJ
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25MA03948900
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License Number State | NJ
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