| NPI | 1548326069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN WAGNER Director Of Outpatient Services 732-290-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: NJ 100050104) |
| Additional Taxonomies | 251S00000X (Licence: NJ 2000341) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2020-03-12 |