| NPI | 1295141745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADA SHAKOV Owner 732-333-3747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25ma08359100) |
| Enumeration Date | 2014-07-05 |
| Last Update Date | 2015-06-12 |