NPI | 1194395269 |
---|---|
Entity Type | Organization |
Authorized Contact | PATRICIA BENIQUEZ PACHECO Credentialing Supervisor 201-833-3599 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2021-06-30 |
Last Update Date | 2024-05-08 |