Provider Demographics
NPI:1285775114
Name:INTERNAL MEDICINE ASSOCIATES AT PRINCETON, LLC
Entity type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES AT PRINCETON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-921-3362
Mailing Address - Street 1:281 WITHERSPOON ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-3210
Mailing Address - Country:US
Mailing Address - Phone:609-921-3362
Mailing Address - Fax:609-921-3584
Practice Address - Street 1:281 WITHERSPOON ST
Practice Address - Street 2:SUITE 220
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3210
Practice Address - Country:US
Practice Address - Phone:609-921-3362
Practice Address - Fax:609-921-3584
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRINCETON INTERNAL MEDICINE ASSOCIATES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-12
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty