| NPI | 1275992653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN ETTENHUBER Credentialing COO Rdinator 732-560-9176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: NJ 25MA03593300) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2016-02-15 |