| NPI | 1649663188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARJORIE M CONDON Owner/Provider 973-839-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MB05411900) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |