| NPI | 1629405204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY D STARK Owner/Operator 973-714-2414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: NJ MC004958) |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2013-09-27 |