| NPI | 1457896003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RIZKALLA Director 856-983-9001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine |
| Additional Taxonomies | 261QP3300X Clinic/Center Pain (Licence: NJ 25MA08922900) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2024-01-31 |