1316219900 NPI number — PRINCETON NEUROLOGICAL SURGERY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316219900 NPI number — PRINCETON NEUROLOGICAL SURGERY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRINCETON NEUROLOGICAL SURGERY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1316219900
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 WARNER ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HOPE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18938-9226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-882-3100
Provider Business Mailing Address Fax Number:
609-882-3400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3836 QUAKERBRIDGE ROAD SUITE 203
Provider Second Line Business Practice Location Address:
PRINCETON NEUROLOGICAL SURGER
Provider Business Practice Location Address City Name:
HAMILTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-890-3400
Provider Business Practice Location Address Fax Number:
309-890-3410
Provider Enumeration Date:
01/30/2012

Additional Information

Authorized Official

Authorized Official Last Name:
LIPANI
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
215-272-0834

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  25MA08134300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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