| NPI | 1689089047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA ADELE JONES Speech Therapist 732-455-5504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: NJ 41YS00774600) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: NJ 41YS00774600) |
| 302R00000X Health Maintenance Organization (Licence: NJ 41YS00774600) | |
| 305S00000X Point of Service (Licence: NJ 41YS00774600) | |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |