| NPI | 1255985677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD PESCATORE Medical Director 856-305-3863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0015X Psychiatry & Neurology, Psychosomatic Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 208VP0000X | |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2019-07-25 |