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NPI Code Detail

MEDICARE: COMPASS HEALTH GROUP

MEDICARE: COMPASS HEALTH GROUP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician
2207QA0401XAddiction Medicine (Family Medicine) Physician
3207R00000XInternal Medicine Physician
4207RA0401XAddiction Medicine (Internal Medicine) Physician
5208VP0000XPain Medicine Physician
6208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1134484868
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMPASS HEALTH GROUP
Provider Business Mailing Address
First Line : 4065 QUAKERBRIDGE RD
Second Line :
City : PRINCETON JUNCTION
State : NJ
Zip : 08550-5243
Country : US
Telephone Number : 609-482-3701
Fax Number : 215-975-7300
Provider Business Practice Location Address
First Line : 4065 QUAKERBRIDGE RD
Second Line :
City : PRINCETON JUNCTION
State : NJ
Zip : 08550-5243
Country : US
Telephone Number : 609-482-3701
Fax Number : 215-975-7300
Authorized Official
Title or Position : ADMINISTRATOR
Name : MARY NAOMI
Credential :
Telephone Number : 609-482-3701
Provider Enumeration Date : 07/09/2012
Last Update Date : 07/09/2012

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