Basic Information
| Provider Information | |||||||||
| NPI: | 1124499041 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUNTERDON SPECIALTY CARE, PC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HUNTERDON UROLOGICAL ASSOCIATES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 MINNEAKONING RD | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088225726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082841125 | ||||||||
| FaxNumber: | 9082842016 | ||||||||
| Practice Location | |||||||||
| Address1: | 121 HIGHWAY 31 | ||||||||
| Address2: | SUITE 1200 | ||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088225744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087820019 | ||||||||
| FaxNumber: | 9087820630 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2015 | ||||||||
| LastUpdateDate: | 10/19/2015 | ||||||||
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| AuthorizedOfficialLastName: | SKILLINGE | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT, MEDICAL PRACTICES | ||||||||
| AuthorizedOfficialTelephone: | 9087886160 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | D.O, | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Urology |
No ID Information.