| NPI | 1053510131 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIE RACHUNOW Owner/President 973-575-7342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 220017) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2009-03-17 |