| NPI | 1164605531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ROBERT IVAN Managing Member 732-271-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA05501700) |
| Enumeration Date | 2007-12-08 |
| Last Update Date | 2007-12-08 |