| NPI | 1083995468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRYAM D REVOREDO Manager 973-595-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 217042-1) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 217042-1) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2011-08-30 |