| NPI | 1447206420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MITCHELL Director Of Credentialing 732-867-9618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-02-01 |