| NPI | 1598791063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES CHANDLER Physician Assistant 973-986-4013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NJ mp00056300) |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2020-08-22 |