| NPI | 1548931504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAM ORTIZ Office Manager 201-716-9199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 111NR0400X Chiropractor, Rehabilitation | |
| 207QA0505X Family Medicine, Adult Medicine | |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2023-01-18 |