| NPI | 1114065414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACINTO FERNANDEZ Delegated Official 201-907-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA02831100) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-09-12 |