| NPI | 1265758742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NELSON MEDRANO Director 177-079-2027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA05369700) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MA06683000) |
| 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA04247500) | |
| 208D00000X General Practice (Licence: NJ 25MA02420000) | |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2010-04-09 |