| NPI | 1083159495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRIGORY S. RASIN Owner 908-686-4145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA04227500) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA06556300) |
| Enumeration Date | 2016-12-21 |
| Last Update Date | 2017-01-11 |