| NPI | 1629428651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SRULEVICH President 917-776-9050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: NJ 38mc00628300) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |