Basic Information
| Provider Information | |||||||||
| NPI: | 1750739660 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUNTERDON AMBULATORY SERVICES LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 WESTCOTT DR | ||||||||
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| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087886100 | ||||||||
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| Address1: | 2100 WESTCOTT DR | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08822 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9087886100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2016 | ||||||||
| LastUpdateDate: | 01/17/2017 | ||||||||
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| AuthorizedOfficialLastName: | HOSKINS | ||||||||
| AuthorizedOfficialFirstName: | DEBORAH | ||||||||
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| AuthorizedOfficialTitleorPosition: | VICE PRESIDENT, FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 9087886429 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HUNTERDON MEDICAL CENTER SOLE MBR | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Psychologist | Clinical | 207RI0011X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | 2085R0204X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 261QP2000X | N | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | 208D00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.