| NPI | 1538547112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARDY VALENTIN Medical Director 862-955-3232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MP00192500) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: NJ 25MA08826900) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2016-07-27 |