| NPI | 1023062163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER W KULISCHENKO Prop./Owner 732-613-9155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA43009) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2007-10-16 |