| NPI | 1295915304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS CAMPOS President 973-589-0767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ 25ma0265000) |
| Enumeration Date | 2007-11-06 |
| Last Update Date | 2007-11-06 |