| NPI | 1316184112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATIANA SHTERN Owner 201-712-1599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NJ MA 71301) |
| Enumeration Date | 2009-01-15 |
| Last Update Date | 2009-01-15 |