| NPI | 1629027503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN CHARLES WEINER President 732-972-6996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty (Licence: NJ 24114) |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2007-07-30 |