| NPI | 1104181452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SERGE MENKIN Medical Director 732-226-5552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MA07263400) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NJ 38MC00644200) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ 25MA08003800) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-25 |