| NPI | 1114371697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN P DELAURENTIS Administrator 609-481-5830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NJ 25MB05189200) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: NJ SI00144600) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |