| NPI | 1487100657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN EKWALL Administrator 973-483-3444 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05479500) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2017-04-12 |