| NPI | 1558696310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY FIELDS Office Manager 201-456-7920 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: NJ 35s100219800) |
| Enumeration Date | 2009-10-13 |
| Last Update Date | 2009-10-13 |