Provider Demographics
NPI:1154989341
Name:SENIOR CARE OF PRINCETON
Entity type:Organization
Organization Name:SENIOR CARE OF PRINCETON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GIMBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-455-7228
Mailing Address - Street 1:50 PRINCETON HIGHTSTOWN RD STE 170
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1107
Mailing Address - Country:US
Mailing Address - Phone:609-455-7228
Mailing Address - Fax:609-228-5209
Practice Address - Street 1:50 PRINCETON HIGHTSTOWN RD STE 170
Practice Address - Street 2:
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-1107
Practice Address - Country:US
Practice Address - Phone:609-455-7228
Practice Address - Fax:609-228-5209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-03
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care