Provider Demographics
NPI:1285292276
Name:PRINCETON BRAIN & SPINE, LLC
Entity type:Organization
Organization Name:PRINCETON BRAIN & SPINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-921-9001
Mailing Address - Street 1:731 ALEXANDER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-6345
Mailing Address - Country:US
Mailing Address - Phone:609-921-9001
Mailing Address - Fax:
Practice Address - Street 1:731 ALEXANDER RD STE 200
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-6345
Practice Address - Country:US
Practice Address - Phone:609-921-9001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies