| NPI | 1366047144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANG GREGORY Partner 732-266-3994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208D00000X General Practice | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2025-02-12 |