| NPI | 1275979700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WOLSTEIN Medical Director 201-620-8396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME17577) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2013-07-01 |