| NPI | 1700184884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA C MCCORMACK Owner 201-926-6151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: NY 161216) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: NJ 25MA04075800) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2013-05-28 |