| NPI | 1174958847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY RUSSO Owner 201-468-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 2083X0100X Preventive Medicine, Occupational Medicine | |
| Enumeration Date | 2013-09-12 |
| Last Update Date | 2015-05-06 |