| NPI | 1689183311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOIS BONANNO Secretary 732-549-2220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: NJ 25MAO6566600) |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2022-07-21 |