| NPI | 1255516050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON CARDONA Billing Account Representative 800-572-0809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MA31840) |
| Enumeration Date | 2007-12-31 |
| Last Update Date | 2007-12-31 |