| NPI | 1003824624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN A. MALON Operating Manager 973-940-0116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NC04592400) |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2012-01-10 |