| NPI | 1588176929 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENITA OGLESBY Owner 973-592-2733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB08472400) |
| Additional Taxonomies | 261QX0100X Clinic/Center, Occupational Medicine |
| Enumeration Date | 2017-10-25 |
| Last Update Date | 2017-10-25 |