| NPI | 1073981361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGED T BOUTROS Owner 973-777-3711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MA08097300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08097300) |
| Enumeration Date | 2015-09-03 |
| Last Update Date | 2022-07-21 |