# PRINCETON MEDICAL & AESTHETICS CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PRINCETON MEDICAL & AESTHETICS CENTER LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275126211
- **Authorized official:** SHIVA JETTY MD (MD)
- **Authorized official phone:** (609) 874-0070

## Contact information

- **Practice address:** 61 PRINCETON HIGHTSTOWN RD \# 2C, PRINCETON JUNCTION, NJ 08550-1120
- **Practice address phone:** (609) 874-0070
- **Practice address fax:** (609) 874-0029
- **Mailing address:** 61 PRINCETON HIGHTSTOWN RD \# 2C, PRINCETON JUNCTION, NJ 08550-1120
- **Mailing address phone:** (609) 874-0070
- **Mailing address fax:** (609) 874-0029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/19/2021
- **Last updated:** 02/19/2021