| NPI | 1548615040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROTH LEON RILEY Director 201-794-4500 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: NJ 25ma09551100) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46TR00608400) |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2022-07-21 |