NPI | 1215288386 |
---|---|
Entity Type | Organization |
Authorized Contact | AMBALAVANER KRISHNAMOORTHY Physician Director 908-753-5771 |
Organization Subpart ? | Yes |
Primary Taxonomy | 174400000X Specialist (Licence: NJ MA53719) |
Additional Taxonomies | 174400000X Specialist (Licence: NJ MA44629) |
Enumeration Date | 2012-09-28 |
Last Update Date | 2012-09-28 |