| NPI | 1679702476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAL THOMAS LAFORGIA Shareholder 732-557-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2009-07-14 |
| Last Update Date | 2015-10-08 |