| NPI | 1003328824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANA ERGARDT Manager 201-613-6174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| 207RR0500X Internal Medicine, Rheumatology | |
| 111N00000X Chiropractor | |
| 207KA0200X Allergy & Immunology, Allergy | |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2023-11-13 |