| NPI | 1376303677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADAN ILKHANI Cmo 732-510-0460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 261QI0500X Clinic/Center Infusion Therapy | |
| Enumeration Date | 2024-03-21 |
| Last Update Date | 2024-03-21 |