| NPI | 1487156634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA ORTIZ Office Manager 201-716-9199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2023-06-27 |