| NPI | 1699322867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLANDO DOMINGUEZ MUSTAFA Owner 973-610-6389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine, Adolescent Medicine |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2025-08-29 |