| NPI | 1104256130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA BENIQUEZ PACHECO Credentialing Supervisor 201-833-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207X00000X Orthopaedic Surgery | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2013-11-12 |
| Last Update Date | 2025-05-07 |