| NPI | 1548429020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE G WESLOW President 201-784-0071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: NJ MA64674) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NJ MA64674) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2008-06-09 |