| NPI | 1366745176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN M. CERTAGENA Office Manager 609-581-9099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA079438) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA0549300) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2010-12-16 |