| NPI | 1285079590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY STEPAN BOZIAN President 973-824-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: NJ Mc03260) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NJ 38MCOO326000) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2013-05-01 |