| Garden State Physicians P.c. | |
|
10 Jefferson Plz Ste. 100 Princeton NJ 08540-9542 | |
| (732) 274-1274 | |
| (732) 355-0321 |
| Full Name | Garden State Physicians P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 10 Jefferson Plz, Princeton, New Jersey |
| Authorized Official Name and Position | Sonia Deora (DIRECTOR) |
| Authorized Official Contact | 7322741274 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Garden State Physicians P.c. 10 Jefferson Plz Ste. 100 Princeton NJ 08540-9502 Ph: (732) 274-1274 | Garden State Physicians P.c. 10 Jefferson Plz Ste. 100 Princeton NJ 08540-9542 Ph: (732) 274-1274 |
| NPI Number | 1518115542 |
|---|---|
| Provider Enumeration Date | 09/03/2008 |
| Last Update Date | 10/08/2014 |
| Medicare PECOS PAC ID | 5193887370 |
|---|---|
| Medicare Enrollment ID | O20081222000646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518115542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MB068932 (New Jersey) | Secondary |
| 207R00000X | Internal Medicine | MA67505 (New Jersey) | Primary |
| Provider Name | Srinivas Mendu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245235126 PECOS PAC ID: 4082776265 Enrollment ID: I20081223000242 |
| Provider Name | Sonia Deora |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235134297 PECOS PAC ID: 3173685351 Enrollment ID: I20081223000342 |
| Provider Name | Sangeeta Buddala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659460509 PECOS PAC ID: 2264613033 Enrollment ID: I20110228000141 |
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