| NPI | 1609026798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFRED T. C. PENG Manager 561-251-6781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ 25MA05520200) |
| Enumeration Date | 2008-09-24 |
| Last Update Date | 2009-02-23 |