| NPI | 1558780379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON M REGIS Owner 609-272-0655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: NJ 25MD00197100) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MA07552100) |
| 207V00000X Obstetrics & Gynecology (Licence: NJ 25MA03856300) | |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2014-04-09 |