NPI | 1346400033 |
---|---|
Entity Type | Organization |
Authorized Contact | FRED D. GANGEMI Medical Director 732-747-1035 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MA04340200) |
Enumeration Date | 2008-06-16 |
Last Update Date | 2008-06-16 |