| NPI | 1538397773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN GEORGE RASSIAS Owner 732-259-3037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ 22dio2162500) |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2009-06-25 |