| NPI | 1255084786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN RUNDBACK Owner/Authorized Offical 973-947-6586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2025-06-10 |