| NPI | 1417282922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CALVIN CHATLOS Sole Proprietor 732-414-6001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: NJ MA 46262) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine (Licence: NJ MA 46262) |
| 2084P0802X Psychiatry & Neurology Addiction Psychiatry (Licence: NJ MA 46262) | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: NJ MA 46262) | |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |