| NPI | 1063670578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMITRA DENISE PALLIS Director Of Credentialing 201-874-9084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2018-07-18 |