| NPI | 1114004546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN KOUKIAS Office Manager 908-454-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB033577) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2019-04-26 |