| NPI | 1710192406 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE LETTIERE Owner 201-650-6165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: NJ 40QA00296000) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2015-04-24 |