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General NPI Number Information
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NPI Number | 1902185945
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Entity Type | Organization
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Legal Business Name | PRINCETON EYE & EAR LLC
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Dates
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Enumeration Date | 08/09/2011
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Last Update Date | 05/23/2013
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Provider Practice Location Address
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Address Line | 2999 PRINCETON PIKE
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-3261
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Country | US
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Telephone | 609-403-8843
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 398
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City | BORDENTOWN
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State | NJ
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Zip | 08505-0398
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CHETAN SHAH
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Credential |
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Telephone | 609-403-8843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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