| NPI | 1710689633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LONGA PETER Authorized Official/Owner 908-642-5417 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-01-22 |