| NPI | 1063965341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL WHITE Office Manager 732-743-5910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: OH 35.080772) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-10 |