| NPI | 1396113064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RATNA VEDULLAPALLI Member, Owner 908-930-1938 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CT 010135) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2015-09-10 |