| NPI | 1376939199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOLA FADIPE Family Nurse Practitioner 862-576-2061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 26nj00468500) |
| Enumeration Date | 2015-04-08 |
| Last Update Date | 2015-04-08 |