| NPI | 1407028657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX RODRIGO PAVON Owner 201-503-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ 25MA07135200) |
| Enumeration Date | 2008-03-27 |
| Last Update Date | 2008-04-07 |