| NPI | 1336538305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBERE DIRIBE Apn 973-735-8531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 26NJ00186400) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: NJ 26NJ00186400) |
| 208D00000X General Practice (Licence: NJ 25MA03964100) | |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2016-07-13 |