| NPI | 1508540006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOSES JACOBS Director 973-241-5856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2025-01-21 |