| NPI | 1154720613 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON M REGIS Owner 609-272-0655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA07552100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA04388900) |
| 208000000X Pediatrics (Licence: NJ 25MA03906000) | |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2014-08-20 |