| 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 | 2025-05-12 |