| NPI | 1669717864 |
|---|---|
| Doing Business As | AVENEL ISELIN MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Ops 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: NJ 25MA05991500) |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2012-11-29 |