Provider Demographics
NPI:1487483095
Name:PERFORMANCE MEDICAL GROUP OF HILLSBOROUGH LLC
Entity type:Organization
Organization Name:PERFORMANCE MEDICAL GROUP OF HILLSBOROUGH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDEBRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-756-2424
Mailing Address - Street 1:1011 US HIGHWAY 22 STE 203
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2979
Mailing Address - Country:US
Mailing Address - Phone:908-756-2424
Mailing Address - Fax:
Practice Address - Street 1:105 RAIDER BLVD STE 201
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-1528
Practice Address - Country:US
Practice Address - Phone:908-756-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-31
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty