| NPI | 1477046092 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO CICCONE Medical Director 973-751-2060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: NJ 25MB05752300) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2018-06-08 |