| NPI | 1154149573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH PARKS Chief Medical Director 201-474-5844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2024-10-03 |