| NPI | 1427003904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA LAZARUS Credentialing Coordinator 856-356-4001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: PA 00178701) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA 109639) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2016-11-25 |