| NPI | 1235822784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETTIE TRESS Owner 732-486-7373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LG0600X Nurse Practitioner, Gerontology | |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2023-06-22 |