| NPI | 1669646642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARVEY RICHARD JACOBS Owner 732-873-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ 25MD00105100) |
| Enumeration Date | 2008-04-21 |
| Last Update Date | 2009-01-16 |