Basic Information
| Provider Information | |||||||||
| NPI: | 1851033146 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HUNTERDON SPECIALTY CARE, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3 MINNEAKONING RD | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088225726 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082841125 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6 SAND HILL RD STE 202 | ||||||||
| Address2: | |||||||||
| City: | FLEMINGTON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088224946 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082374080 | ||||||||
| FaxNumber: | 9082371749 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/08/2022 | ||||||||
| LastUpdateDate: | 04/08/2022 | ||||||||
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| AuthorizedOfficialLastName: | BERMONTIZ | ||||||||
| AuthorizedOfficialFirstName: | WANDA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF CENTRAL BILLING OFFICE | ||||||||
| AuthorizedOfficialTelephone: | 9082841125 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HUNTERDON SPECIALTY CARE, PC | ||||||||
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| NPICertificationDate: | 04/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0402X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology |
No ID Information.