| NPI | 1366591950 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY JACOB Registered Nurse 201-314-1589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse General Practice (Licence: NY 575279-1) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2020-08-22 |