| NPI | 1154622579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS MANGANELLI Medical Director 732-730-3939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2019-11-19 |