NPI | 1619025038 |
---|---|
Entity Type | Organization |
Authorized Contact | DOREE VANDENBERGH Credentialer/Director 908-684-3005 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: NJ 25MB06971100) |
Additional Taxonomies | 174400000X Specialist (Licence: NJ 25MB06992500) |
Enumeration Date | 2007-01-08 |
Last Update Date | 2009-11-06 |