| NPI | 1518021039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAEWON MOON Director 201-503-0066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NJ 25MA05670900) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2014-07-23 |