| NPI | 1326813742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA P SHUKLA Owner, Provider 201-620-6166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-11-15 |
| Last Update Date | 2024-12-19 |