| NPI | 1073261475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD RAYMOND TYAS Practice Administrator 732-272-5685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2022-03-15 |
| Last Update Date | 2024-03-18 |