| NPI | 1487864997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WEDAD S MICHAEL Member 609-677-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: NJ 25MA05942900) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |