| NPI | 1588930663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LENIS GONZALEZ M.D. 201-569-5151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ 207N00000X) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2012-03-22 |