| NPI | 1407264658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERY FRADKOV Clinical Director 201-497-0289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05391100) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |