| NPI | 1104666197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICKSON ANGEN BALDERA GARCES Primary Care Physician 201-993-1475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2024-05-28 |
| Last Update Date | 2024-05-28 |