| NPI | 1457722803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHMAN ASHRAF Medical Director 732-439-8223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ 25MA04648400) |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2015-10-12 |