1922465632 NPI number — PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC

Table of content: MRS. DARIAN L. UNDERWOOD OT (NPI 1770871097)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922465632 NPI number — PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRINCETON HEALTHCARE AFFILIATED PHYSICIANS PC
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:
1922465632
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 PRINCESS RD
Provider Second Line Business Mailing Address:
SUITE 207
Provider Business Mailing Address City Name:
LAWRENCEVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08648-2322
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-243-0445
Provider Business Mailing Address Fax Number:
609-844-1092

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
666 PLAINSBORO RD
Provider Second Line Business Practice Location Address:
BUILDING 1300, SUITE 1316
Provider Business Practice Location Address City Name:
PLAINSBORO
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08536-3047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-275-8100
Provider Business Practice Location Address Fax Number:
609-275-6133
Provider Enumeration Date:
01/26/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BERGMANN
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
609-853-7220

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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