| NPI | 1497069314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERMIN J LEON Owner 201-863-8342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25ma03535900) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NJ 25ma03535900) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2010-08-03 |