| NPI | 1164739447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN R MOGAN Owner 973-731-8686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA037333) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2010-09-08 |