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 |