| NPI | 1023204336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M HIGGINS Doctor 201-488-4412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ ma06926700) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2009-04-01 |