| NPI | 1346449881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD JOSEPH GLAVEY Owner/Provider 201-420-7903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MB07615600) |
| Enumeration Date | 2007-07-14 |
| Last Update Date | 2023-03-07 |