NPI | 1225450364 |
---|---|
Entity Type | Organization |
Authorized Contact | ROSAIRE B LAINE CEO 973-220-8313 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NY 199824) |
Additional Taxonomies | 261QC1500X Clinic/Center, Community Health (Licence: NY F304165-1) |
Enumeration Date | 2014-01-08 |
Last Update Date | 2025-09-19 |