| NPI | 1720145410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY J. DE BLASIO Executive Director 609-924-8018 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NJ 41140) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2019-09-16 |