| NPI | 1164148672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IYAD BAKER Owner 201-596-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 103TA0700X Psychologist, Adult Development & Aging | |
| Enumeration Date | 2022-10-17 |
| Last Update Date | 2022-10-17 |