| NPI | 1104258102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY KONDAS Officer 973-251-1132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2013-08-01 |
| Last Update Date | 2019-12-06 |