| NPI | 1487039806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA C. LANE Clinical Director 856-389-5579 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP3300X Clinic/Center, Pain | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2016-11-11 |