IVY LEAGUE HEALTH & FITNESS (NPI# 1760641757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760641757 |
| Entity Type | Organization |
| Organization Name | IVY LEAGUE HEALTH & FITNESS |
| Other Organization Name | SOURCE INSTITUTE FOR HUMAN PERFORMANCE |
| Practice Address |
66 Witherspoon St Princeton NJ 08542-3239 |
| Mailing Address |
66 Witherspoon St Pmb 403 Princeton NJ 08542-3226 |
| Practice Telephone | 6099251159 |
| Mailing Telephone | 6099251159 |
| Mailing Fax Number | 6099251159 |
| Enumeration Date | 2008-06-04 |
| Last Update Date | 2011-10-30 |
| Authorized Official Name | MR. DAVID NOGAKI (DIRECTOR OF TRAINING) |
| Authorized Official Telephone | 6099251159 |
| Authorized Official Credential | C.S.C.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| SOURCE Institute for Human Performance | Doing Business As Name - Organization |
| Street Address |
66 WITHERSPOON ST |
| City | PRINCETON |
| State | NJ |
| Zip Code | 08542-3239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235435025 | Tnc Enterprises | Specialist | 66 Witherspoon St, Pmb 403, Princeton, NJ 08542-3239 | 2011-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811354822 | Brooke Sweet | Psychologist | 20 Nassau Street, Suite 409, Princeton, NJ 08542 | 2016-01-21 |
| 1598024523 | Libby Zinman Schwartz | Counselor | 43c Palmer Square West, Princeton, NJ 08542 | 2012-05-11 |
| 1164796132 | Beth W. Smith | Social Worker | 20 Nassau St Ste 234b, Princeton, NJ 08542 | 2012-03-08 |
| 1275801144 | Mary Ann Godefroy | Counselor | 17 Chestnut Street, Princeton, NJ 08542 | 2011-12-07 |
| 1639458607 | Pierina Thayer | Counselor | 40 Witherspoon Street, Princeton, NJ 08542 | 2011-08-09 |
| 1083906655 | Amy Elizabeth Bibb | Social Worker | 20 Nassau St Ste 111, Princeton, NJ 08542 | 2011-05-13 |
| 1043538184 | Princeton Premier Medicine, LLC | Internal Medicine | 281 Witherspoon Street, Suite 220, Princeton, NJ 08542 | 2010-05-13 |
| 1790944551 | Mercedes Kennedy | Psychologist | 195 Nassau Street Office #28, Princeton, NJ 08542 | 2008-06-06 |
| 1124152350 | Janet Beth Merkin Weistuch | Social Worker | 194 Nassau St, Princeton, NJ 08542 | 2007-03-16 |
| 1235281890 | Norman Martin Weistuch | Psychologist | 194 Nassau Street, Princeton, NJ 08542 | 2007-01-16 |
| Find all providers in zip 08542 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841611464 | Bright Life Farms, Inc | Specialist | 10200 Farmersville Rd, Princeton, KY 42445-5340 | 2013-12-27 |
| 1497188981 | Daniel I. Shrager M.d., LLC | Specialist | 19 Coniston Ct, Princeton, NJ 08540-7552 | 2013-08-20 |
| 1730439712 | Jo Ann Noxon Laveman | Specialist | 16 E Countryside Dr, Princeton, NJ 08540-9406 | 2012-09-17 |
| 1023363827 | A & E Anesthesia Associate LLC | Specialist | 601 Ewing Street, Suite C-3, Princeton, NJ 08540 | 2012-07-17 |
| 1982983995 | Steven Lee Collins | Specialist | 313 Court House Road Suite 2, Princeton, WV 24739 | 2011-08-08 |
| 1558652297 | Steven Lee Terry | Specialist | 201 Wallace St, Princeton, WV 24740-2754 | 2011-04-28 |
| 1366671745 | Bonnie G Carter | Specialist | 108 Mill St, Princeton, ME 04668-3344 | 2009-07-07 |
| 1407080229 | Valeria Malone Jones | Specialist | 116 S. Center St., Princeton, NC 27569 | 2009-05-07 |
| 1780874370 | Joseph Orthopedic Surgery, P.a. | Specialist | 1808 Sherman Dr Ste 2203, Princeton, IN 47670-1043 | 2007-07-30 |
| 1124242474 | Jennifer Loraine Lister | Specialist | Caldwell Fieldhouse, Faculty Road, Princeton, NJ 08544-0001 | 2007-04-11 |
| Find all providers in PRINCETON | ||||
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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.