| NPI | 1497100861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA MARIE RUNNE Medical Biller 973-697-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X |
| Additional Taxonomies | 347C00000X Private Vehicle |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2016-05-04 |