| NPI | 1679341523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN NIETO Credential Spec. 973-580-3112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2024-01-31 |