Provider Demographics
NPI:1194135293
Name:PRINCETON A MUNICIPAL ORGANIZATION
Entity type:Organization
Organization Name:PRINCETON A MUNICIPAL ORGANIZATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:GROSSER
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, HO, REHS
Authorized Official - Phone:609-497-7608
Mailing Address - Street 1:400 WITHERSPOON ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-3400
Mailing Address - Country:US
Mailing Address - Phone:609-497-7608
Mailing Address - Fax:609-924-7627
Practice Address - Street 1:45 STOCKTON ST
Practice Address - Street 2:SUZANNE PATTERSON BUILDING
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6812
Practice Address - Country:US
Practice Address - Phone:609-924-7108
Practice Address - Fax:609-924-9305
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-29
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare