MEDICAL CENTER AT PRINCETON PEDIATRIC CLINIC (NPI# 1629286000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629286000 |
| Entity Type | Organization |
| Organization Name | MEDICAL CENTER AT PRINCETON PEDIATRIC CLINIC |
| Practice Address |
253 Witherspoon St Suite B Princeton NJ 08540-3211 |
| Mailing Address |
3626 Us Highway 1 Princeton NJ 08540-5922 |
| Practice Telephone | 6094974240 |
| Mailing Telephone | 6097347600 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | BRUCE TRAUB (CFO) |
| Authorized Official Telephone | 6094974077 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 6172300 | 05 |
| Street Address |
253 WITHERSPOON ST SUITE B |
| City | PRINCETON |
| State | NJ |
| Zip Code | 08540-3211 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306823778 | Andrew Hanyoung Kim | Anesthesiology | 253 Witherspoon St, Princeton Anesthesia Services, Princeton, NJ 08540-3211 | 2005-12-28 |
| 1083955967 | Caitlin M Werther | Nurse Practitioner | 253 Witherspoon St, Princeton, NJ 08540-3211 | 2013-03-03 |
| 1932468014 | Maggie Moran | Counselor | 253 Witherspoon St, Princeton, NJ 08540-3211 | 2012-05-10 |
| 1841559937 | Veronika Papp | Social Worker | 253 Witherspoon St, Princeton, NJ 08540-3211 | 2012-05-09 |
| 1710252382 | Elizabeth Moore | Dietitian, Registered | 253 Witherspoon St, Princeton, NJ 08540-3211 | 2012-03-15 |
| 1457654691 | Jennifer Windish | Dietitian, Registered | 253 Witherspoon St, Princeton, NJ 08540-3211 | 2010-12-09 |
| 1043544182 | Rachel Huber | Dietitian, Registered | 253 Witherspoon St, Princeton, NJ 08540-3211 | 2009-09-22 |
| 1114251436 | Allison Tara Lansky | Counselor | 253 Witherspoon St, Princeton, NJ 08540-3211 | 2009-09-21 |
| 1770817090 | Margo Leigh Hurewitz | Psychologist | 253 Witherspoon St, Princeton, NJ 08540-3211 | 2009-09-21 |
| 1477796811 | Jennifer Grantham Erskine | Internal Medicine | 253 Witherspoon St, Lambert House 2nd Floor, Princeton, NJ 08540-3211 | 2009-04-15 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420613 | Samantha Beatriz Manzano | Pharmacist | 301 N Harrison Street, Princeton, NJ 08540 | 2020-09-01 |
| 1306485768 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 414 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1124667589 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 415 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1215576673 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 416 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1508405929 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 411 Freedom Blvd, Princeton, NJ 08540 | 2020-01-02 |
| 1992369698 | Suzanne Haggerty | Social Worker | 716 Executive Drive, Princeton, NJ 08540 | 2019-04-28 |
| 1700349552 | Pdp Associates LLC | Social Worker | 3490 Us Highway 1, Building 16 Suite 112, Princeton, NJ 08540 | 2019-04-09 |
| 1245722438 | Kyle Bonner | Social Worker | 166 Bunn Dr Ste 105, Princeton, NJ 08540 | 2018-06-04 |
| 1942700125 | Lifetouch Behavioral Health, LLC | Community/Behavioral Health | 112 Commons Way, Building 1, Suite 112, Princeton, NJ 08540 | 2018-02-14 |
| 1912407271 | Princeton Psychiatry & Consulting, LLC | Psychiatry & Neurology | 601 Ewing St, Suite C-10, Princeton, NJ 08540 | 2018-02-13 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942618665 | Elena Altshuler | Pediatrics | 256 Bunn Dr Ste 3a, Princeton, NJ 08540-2859 | 2014-07-25 |
| 1508272170 | Jaishree Ramachandran | Pediatrics | 1 Bellaire Dr, Princeton, NJ 08540-7824 | 2014-07-03 |
| 1679729354 | Kim Hutchins Millar | Pediatrics | 301 N. Harrison St., Princeton Nassau Pediatrics, Princeton, NJ 08540 | 2008-08-13 |
| 1407023963 | Norman Steve Katz | Pediatrics | 11 Oak Place, Princeton, NJ 08540 | 2008-05-14 |
| 1588735690 | Jennifer X. Luan | Pediatrics | 12 Roszel Rd Ste A101, Princeton, NJ 08540-6234 | 2006-11-11 |
| 1871679100 | John M Cotton | Pediatrics | 66 Mt Lucas Road, Princeton, NJ 08540-2733 | 2006-10-30 |
| 1558464172 | M S Krishna | Pediatrics | 312 North 3rd Ave, Princeton, IN 47670 | 2006-09-07 |
| 1588638522 | Helen M Rose | Pediatrics | 281 Witherspoon St Ste 200, Princeton, NJ 08540 | 2006-02-15 |
| 1710963863 | David Matthew Krol | Pediatrics | 148 Bertrand Dr, Princeton, NJ 08540-2904 | 2005-12-21 |
| 1477536597 | Allen J. Schneider | Pediatrics | 301 N Harrison St, Princeton Nassau Pediatrics, Princeton, NJ 08540-3512 | 2005-11-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.