Provider Demographics
NPI:1609482926
Name:HUNTERDON PRIMARY CARE PC
Entity type:Organization
Organization Name:HUNTERDON PRIMARY CARE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMONTIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-284-1125
Mailing Address - Street 1:3 MINNEAKONING RD
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5726
Mailing Address - Country:US
Mailing Address - Phone:908-284-1125
Mailing Address - Fax:
Practice Address - Street 1:200 ROUTE 31 STE 105
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5812
Practice Address - Country:US
Practice Address - Phone:908-782-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HUNTERDON PRIMARY CARE PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty