| NPI | 1609144005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRYAM REVOREDO General Manegar 973-595-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA07147400) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |