| NPI | 1336558162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILE IVAN RANGEL Medical Director/President 201-240-2707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ MA066179) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: NJ MA066179) |
| Enumeration Date | 2014-08-06 |
| Last Update Date | 2014-08-06 |