| NPI | 1033658877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACQUEL PETERS Administration Secretary 917-940-0360 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA09998900) |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |