| NPI | 1205176658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL ANDERSON Doctor 732-277-9672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NJ 185799) |
| Enumeration Date | 2013-02-21 |
| Last Update Date | 2013-02-21 |