| NPI | 1225204555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS BARBARA SHERIDAN Office Administrator 973-994-3322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 21943) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-08 |