| NPI | 1083045694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY THEK Direct Owner 201-923-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MA06949100) |
| Enumeration Date | 2013-12-06 |
| Last Update Date | 2023-11-28 |