| NPI | 1063077402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE PALLIS Dir Of Credentialing 201-874-9084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2021-08-10 |