NPI | 1639320153 |
---|---|
Entity Type | Organization |
Authorized Contact | ALLEN R ONGSIAKO Sole Member/Owner 732-505-9333 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB05884600) |
Enumeration Date | 2008-10-02 |
Last Update Date | 2015-06-02 |