| NPI | 1104853100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRES TIANGCO GUEVARRA Owner 856-235-0264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MA04812299) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2020-08-22 |