| NPI | 1659391266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICENTE NEVARDO LOZADA MISION Owner 732-370-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NJ MA038662) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2020-08-22 |