| NPI | 1083475032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDUARDO ARSENIO TIO Provider 732-977-4439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2024-01-17 |
| Last Update Date | 2024-01-17 |