| NPI | 1336710748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA MARIE LICCARDI Sole Proprietor/ Administrator 908-461-8050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2021-08-30 |