| NPI | 1164751103 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWINA SKIBA-KING Sole Member 732-322-5769 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NJ 26NC04861500) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: NJ 26NC04861500) |
| Enumeration Date | 2009-12-22 |
| Last Update Date | 2009-12-22 |