| NPI | 1073652210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND MANZANO VILLONGCO CEO 732-329-1257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07738300) |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: NJ 25MA07738300) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2013-01-04 |