| NPI | 1689369795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEE MAIXNER Owner 973-216-1680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2024-10-15 |