| NPI | 1528115516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDITHA ACANTILADO Office Manager 732-240-5173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine (Licence: NJ 25MA03813900) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2020-08-22 |