Princeton Sleep Medicine Group, P.C.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

BS5438115 Issued in NJ

Legal business name

PRINCETON SLEEP MEDICINE GROUP, P.C.

Practice address

1675 Whitehorse Mercerville Rd
Suite 105
Hamilton, NJ 08619-3825

Phone

(856) 222-9585

Fax

(856) 222-9585

NPI assigned

Oct 3, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dana Supe, MD

Title

Medical Director

Phone

(609) 955-2576

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351728000000",
    "number": "1275885170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 LEEDS RD",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "080571884",
            "telephone_number": "609-955-2576",
            "fax_number": "856-222-9585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 WHITEHORSE MERCERVILLE RD",
            "address_2": "SUITE 105",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086193825",
            "telephone_number": "856-222-9585",
            "fax_number": "856-222-9585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCETON SLEEP MEDICINE GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-03",
        "last_updated": "2012-11-01",
        "status": "A",
        "authorized_official_last_name": "SUPE",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "609-955-2576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NJ",
            "license": "BS5438115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Hamilton, NJ
• Providers in Hamilton, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.