| NPI | 1679585178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LOUIS NEIDORF Owner 856-309-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ 25MA04393800) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2009-12-16 |