| NPI | 1407153802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMA KABAKIBI Office Manager 201-867-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ MA04332) |
| Enumeration Date | 2011-02-21 |
| Last Update Date | 2011-02-21 |