| NPI | 1538789243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE FESTA Owner 772-202-2265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-04-22 |
| Last Update Date | 2020-04-22 |