| NPI | 1598418063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE TERRERO Sr. Director Provider Data Mngmt 201-667-5568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 1041C0700X Social Worker, Clinical | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 208D00000X General Practice | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2023-11-21 |