Provider Demographics
NPI:1538388384
Name:PRINCETON HEALTH CARE SYSTEM
Entity type:Organization
Organization Name:PRINCETON HEALTH CARE SYSTEM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PRIMARY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:H
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:732-589-4605
Mailing Address - Street 1:1460 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1873
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1460 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1873
Practice Address - Country:US
Practice Address - Phone:732-729-3626
Practice Address - Fax:732-435-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00356800251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health