| NPI | 1083371629 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE TERRERO Senior Director Of Compliance 201-667-5568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363L00000X Nurse Practitioner | |
| 1041C0700X Social Worker, Clinical | |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2023-11-21 |