| NPI | 1447696216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN SWOOPE Manager 732-977-4946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ 25MA06184200) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2013-05-20 |