| NPI | 1558811372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE DOMINGO President 609-410-8055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: NJ 25MA06376400) |
| Enumeration Date | 2016-10-04 |
| Last Update Date | 2017-02-27 |