| NPI | 1275983967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMAN KOSIBOROD Medical Director 973-928-3840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MB07566200) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |