| NPI | 1053867598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRIAM BAKER Executive Practice Administrator 201-774-0149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NJ00655100) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |