| NPI | 1386984763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK AIME ERVILUS Provider 856-365-1707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NJ 26NN10322000) |
| Enumeration Date | 2013-02-22 |
| Last Update Date | 2013-06-24 |