| NPI | 1720192891 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN C DEROSA Account Manager 201-986-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: NJ 25MA04269600) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2009-05-28 |