| NPI | 1457460594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN ELIZABETH TIEDEMANN Office Manager 732-388-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ MB27483) |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine (Licence: NJ MB53933) |
| 207R00000X Internal Medicine (Licence: NJ MB71509) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-08-06 |