| NPI | 1417185711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA JENYONS Officer 917-991-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ MA0033221) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA08448100) |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2009-07-16 |