| NPI | 1053514034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA KOWALEWSKI Billing Manager 856-753-0913 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA03433700) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2009-05-22 |