| NPI | 1588187439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON GROSSMAN Podiatrist 732-679-4330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MD00268400) |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2022-10-28 |