| NPI | 1043306574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA BERGER C.E.O. 732-719-1511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2023-09-14 |