| NPI | 1649600453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILI SHUKLA Od/President 908-546-5681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ 27OA00601300) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2020-04-29 |