| NPI | 1396800272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE BERTRAM GROSS Owner 732-246-7440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ 26MA03435600) |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2010-03-26 |