| NPI | 1659243400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE GBOGI Authorized Official 908-205-3790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-22 |
| Last Update Date | 2025-10-14 |