| NPI | 1366827313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY DAISY CANTEY Owner 973-532-7898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA07425300) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NJ 25MA07425300) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2015-08-18 |