| NPI | 1295978385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE ANTHONY DACOSTA President 973-422-0094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ ma56002) |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-04-20 |