MEDICARE: PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	276400000X	Substance Use Disorder Rehabilitation Hospital Unit		NJ
2	273R00000X	Psychiatric Hospital Unit		NJ

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4455360	OTHER	NJ	AETNA CH
2	4606554	OTHER	NJ	AETNA NOB
3	0013018	OTHER	NJ	AETNA PH
4	7383142	OTHER	NJ	AETNA HAM
5	310902	OTHER	NJ	HORIZON MEDI PH
6	6427074	OTHER	NJ	AETNA HERR
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	7350660	OTHER	NJ	AETNA MTL

NPI Number	:	1518009588
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRINCETON HEALTHCARE SYSTEM, A NEW JERSEY NON-PROFIT CORPORATION

Provider Business Mailing Address
First Line	:	905 HERRONTOWN RD
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-1901
Country	:	US
Telephone Number	:	609-497-3300
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 HERRONTOWN RD
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-1901
Country	:	US
Telephone Number	:	609-497-3300
Fax Number	:

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MR. GUILHERME SIMOES VALLADARES
Credential	:
Telephone Number	:	609-853-7112

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	01/28/2026

905 HERRONTOWN RD
PRINCETON, NJ
08540-1901

Practice Phone: 814-366-1315
Practice Fax:

905 HERRONTOWN RD
PRINCETON, NJ
08540-1901