| NPI | 1538555784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP D ROSE Owner 201-357-5468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00182600) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |