| NPI | 1629459953 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIDAGALLE GOWDA Physician/Owner 732-230-2529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NJ 25MA07869800) |
| Enumeration Date | 2015-06-11 |
| Last Update Date | 2015-06-11 |