| NPI | 1477507309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL THEODORE KICENUIK President 732-873-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: NJ 25MA03343200) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2008-09-11 |