| NPI | 1235497561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONN M HOOSACK Owner 732-236-1104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00132300) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2023-03-07 |