| NPI | 1417095845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KETANKUMAR N VAIDYA Owner 732-985-2151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: NJ MA74514) |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2012-06-11 |