| NPI | 1679909030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KESNOLD BAPTISTE President 908-625-7463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: NJ 38mcoo641500) |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2016-08-04 |