Basic Information
| Provider Information | |||||||||
| NPI: | 1295371441 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUNTERDON MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 MINNEAKONING RD | ||||||||
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| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088225726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082841125 | ||||||||
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| Practice Location | |||||||||
| Address1: | 190 ROUTE 31 | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088225773 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087886396 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2019 | ||||||||
| LastUpdateDate: | 11/22/2019 | ||||||||
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| AuthorizedOfficialLastName: | BERMONTIZ | ||||||||
| AuthorizedOfficialFirstName: | WANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9082841125 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HUNTERDON MEDICAL CENTER | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0006X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Developmental – Behavioral Pediatrics |
No ID Information.