| NPI | 1164471017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANCHALI GANGULY Site Medical Director 908-942-9550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ 25MA07547300) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2020-08-22 |