| NPI | 1609087451 |
|---|---|
| Other Name | PARK AVENUE PRIMARY MEDICAL |
| Entity Type | Organization |
| Authorized Contact | DOMICIANO V CAPITLY Medical Doctor 908-561-3934 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2013-10-11 |