| NPI | 1043455314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALYN MICHELLE PONZIO Owner 973-783-0073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07671800) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2008-12-15 |