| NPI | 1356529200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BASEL R ALTAHTAMONI O PT Ician/President 201-420-8162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ 31TD00326600) |
| Enumeration Date | 2008-02-02 |
| Last Update Date | 2008-02-02 |